Individual
DR. JOHN RICHARD BREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
64040 HIGHWAY 434, SUITE 200, LACOMBE, LA 70445-3499
(985) 882-6221
(985) 882-7935
Mailing address
64040 HIGHWAY 434, SUITE 200, LACOMBE, LA 70445-3499
(985) 882-6221
(985) 882-7935
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
018176
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00117913
MEDICAID
MS
05
—
1385221
—
LA
01
—
721349588
TAX ID
LA
Enumeration date
06/16/2005
Last updated
01/26/2022
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