| Breazeal & Associates Pa Inc | |
|
8220 N Cornerstone Dr Ste A, Hayden, ID 83835-8683 | |
| (208) 772-5539 | |
| (208) 772-9382 |
| Full Name | Breazeal & Associates Pa Inc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 8220 N Cornerstone Dr Ste A, Hayden, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295005056 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | ODP-1014 (Idaho) | Primary |
| Provider Name | Larry D Breazeal |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1619049228 PECOS PAC ID: 3779496815 Enrollment ID: I20031106000161 |
| Provider Name | Danielle Johnson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023637733 PECOS PAC ID: 2466872080 Enrollment ID: I20220725002149 |
| Provider Name | Christina R Vogel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1013911866 PECOS PAC ID: 2567356520 Enrollment ID: I20241216002794 |
| Mailing Address | Practice Location Address |
|---|---|
| Breazeal & Associates Pa Inc 8220 N Cornerstone Dr Ste A, Hayden, ID 83835-8683 Ph: (208) 772-5539 | Breazeal & Associates Pa Inc 8220 N Cornerstone Dr Ste A, Hayden, ID 83835-8683 Ph: (208) 772-5539 |
Tyrel J Bruneel, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 8445 N Government Way, Hayden, ID 83835 Phone: 208-772-3208 Fax: 208-762-2574 | |
Dr. Danielle Rae Johnson, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 8220 N Cornerstone Dr Ste A, Hayden, ID 83835 Phone: 208-772-5539 | |
Dr. Robert A Sorensen, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 8445 N Government Way, Hayden, ID 83835 Phone: 208-772-3208 Fax: 208-762-2574 | |
Dr. Daniel Leo Adams, DO Optometrist Medicare: Accepting Medicare Assignments Practice Location: 8220 N Cornerstone Dr Ste A, Hayden, ID 83835 Phone: 208-772-5539 | |
Kyle Andrew Stott, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 8445 N Government Way, Hayden, ID 83835 Phone: 208-772-3208 Fax: 208-762-2574 | |
Hayden Vision Source Pllc Optometrist Medicare: Medicare Enrolled Practice Location: 8445 N Government Way, Hayden, ID 83835 Phone: 208-772-3208 Fax: 208-762-2574 |