Organization Name: | JEFFERY M BUTLER MD PC |
NPI Number: | 1851778823 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEFFERY MILES BUTLER (OWNER) |
Mailing Address: | 950 S Main St Suite 1 Baxley |
State: | GA US |
Postal Code: | 315130162 |
Phone Number: | 9127056866 |
Fax Number: | 9127056867 |
NPI Enumeration Date: | 04/29/2015 |
NPI Last Update Date: | 04/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |