| Dr Richard I Breazeale, MD | |
|
1605 Williams Rd, Ste 201, Hixson, TN 37343-4934 | |
| (423) 756-1512 | |
| (423) 756-1004 |
| Full Name | Dr Richard I Breazeale |
|---|---|
| Gender | Male |
| Speciality | Ophthalmology - Retina Specialist |
| Location | 1605 Williams Rd, Hixson, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801892146 | NPI | - | NPPES |
| 000860318C | Medicaid | GA | |
| 009937405 | Medicaid | AL | |
| 3841514 | Medicaid | TN | |
| 000860318E | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207WX0107X | Ophthalmology - Retina Specialist | 56089 (Georgia) | Secondary |
| 207WX0107X | Ophthalmology - Retina Specialist | 31597 (Tennessee) | Primary |
| Entity Name | Southeastern Retina Associates Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104097310 PECOS PAC ID: 7517862360 Enrollment ID: O20031204000507 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Richard I Breazeale, MD 320 Prosperity Dr, Knoxville, TN 37923-4709 Ph: (423) 756-1512 | Dr Richard I Breazeale, MD 1605 Williams Rd, Ste 201, Hixson, TN 37343-4934 Ph: (423) 756-1512 |
Sophie Cai, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1961 Northpoint Blvd # 11, Hixson, TN 37343 Phone: 423-756-1002 | |
Devon Ghodasra, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1961 Northpoint Blvd Ste 110, Hixson, TN 37343 Phone: 423-756-1002 | |
Asghar Haider, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1961 Northpoint Blvd Ste 110, Hixson, TN 37343 Phone: 423-756-1002 | |
Rohan Shah, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1605 Williams Rd, Ste 201, Hixson, TN 37343 Phone: 423-756-1002 Fax: 423-756-1004 | |
Dr. Francis C Decroos, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1961 Northpoint Blvd Ste 110, Hixson, TN 37343 Phone: 423-756-1002 Fax: 423-756-1004 |