NPI 1801892146 · live from the CMS NPI Registry
Richard I Breazeale, M.D.
Ophthalmology, Retina Specialist in Hixson, TN. National Provider Identifier 1801892146, active.
NPI record
| NPI | 1801892146 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Ophthalmology, Retina Specialist 207WX0107X |
| Practice location | 1605 Williams Rd, Ste 201, Hixson, TN 37343 |
| Practice phone | 423-756-1512 |
| Mailing address | 320 Prosperity Dr, Knoxville, TN 37923 |
| Enumerated | June 22, 2005 |
| Last updated | December 3, 2020 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ophthalmology, Retina Specialist | 207WX0107X | 56089 (GA) |
| Ophthalmology, Retina Specialist primary | 207WX0107X | 31597 (TN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.