Healthcare Provider Details

I. General information

NPI: 1215982475
Provider Name (Legal Business Name): BRAD EVERETTE BUTLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 RAWLS RD
ANGIER NC
27501
US

IV. Provider business mailing address

185 RAWLS RD PO BOX 1833
ANGIER NC
27501
US

V. Phone/Fax

Practice location:
  • Phone: 919-331-2477
  • Fax: 919-331-2481
Mailing address:
  • Phone: 919-331-2477
  • Fax: 919-331-2481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2006-00400
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: