Healthcare Provider Details

I. General information

NPI: 1962231381
Provider Name (Legal Business Name): BRITAIN BUTLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2024
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 W PINE AVE
MERIDIAN ID
83642-5031
US

IV. Provider business mailing address

1873 W TRAVERSE PKWY STE E100
LEHI UT
84048-5985
US

V. Phone/Fax

Practice location:
  • Phone: 801-215-9309
  • Fax: 509-339-8014
Mailing address:
  • Phone: 801-215-9309
  • Fax: 509-339-8014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: