NPI 1619049228

Larry D Breazeal, OD

Practitioner Optometrist Hayden, ID

Practice location

Address: 8220 N Cornerstone Dr STE a, Hayden, ID 83835-8683
Phone: (208) 772-5539
Fax: (208) 772-9382

Registered specialties (2)

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence ODP-1014 (ID)

Other Optometrist providers in Idaho →

Optometrist

Eye and Vision Services Providers Taxonomy 152W00000X Licence OD00003957 (WA)

Registry record

NPI: 1619049228
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Nov 2006
Record last updated: 17 Mar 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.