Healthcare Provider Details

I. General information

NPI: 1881652121
Provider Name (Legal Business Name): MERLIN G. BUTLER M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 12/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEPARTMENT OF PSYCHIATRY KANSAS U MED CTR 3901 RAINBOW BLVD., MAILSTOP 4015
KANSAS CITY KS
66160-0001
US

IV. Provider business mailing address

DEPARTMENT OF PSYCHIATRY KANSAS U MED CTR 3901 RAINBOW BLVD., MAILSTOP 4015
KANSAS CITY KS
66160-0001
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-1873
  • Fax: 913-588-1305
Mailing address:
  • Phone: 913-588-1873
  • Fax: 913-588-1305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number115322
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: