Individual
DR. RICHARD I BREAZEALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1605 WILLIAMS RD, STE 201, HIXSON, TN 37343-4934
(423) 756-1512
(423) 756-1004
Mailing address
320 PROSPERITY DR, KNOXVILLE, TN 37923-4709
(423) 756-1512
(423) 756-1004
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
31597
TN
207WX0107X
Retina Specialist (Ophthalmology) Physician
56089
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000860318C
—
GA
05
—
000860318E
—
GA
05
—
009937405
—
AL
05
—
3841514
—
TN
Enumeration date
06/22/2005
Last updated
12/03/2020
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