Individual
JACK LOUIS BREAUX III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
78 MEDICAL CENTER DR, FISHERSVILLE, VA 22939-2332
(540) 932-4075
Mailing address
PO BOX 388, FISHERSVILLE, VA 22939-0388
(540) 332-5168
(540) 332-5875
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
0101249491
VA
Other
Enumeration date
04/10/2008
Last updated
06/09/2025
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