Doctor Name: | DR. JEFFERY MILES BUTLER |
NPI Number: | 1104036359 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 950 S Main St Suite 1 Baxley, GA - 315130162 |
Business Phone Number: | 9127056866 |
Business Fax Number: | |
Mailing Address: | 821 S Main St, BAXLEY |
State: | GA |
Postal Code: | 315130164 |
Phone Number: | 9123678499 |
Fax Number: | |
NPI Enumeration Date: | 05/23/2007 |
NPI Last Update Date: | 10/01/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |