Provider Demographics
NPI:1427219757
Name:BREARD, JOHN P (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:BREARD
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10401 W. THUNDERBIRD BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351
Mailing Address - Country:US
Mailing Address - Phone:623-977-7211
Mailing Address - Fax:480-256-3682
Practice Address - Street 1:10401 W. THUNDERBIRD BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351
Practice Address - Country:US
Practice Address - Phone:623-977-7211
Practice Address - Fax:480-256-3682
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101250389208G00000X
IL036123839208G00000X
NY276657208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1427219757Medicaid
VAVV2852AMedicare PIN