Healthcare Provider Details

I. General information

NPI: 1295410736
Provider Name (Legal Business Name): MOLLY ELIZABETH BUTE OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2640 HIGHWAY 105 STE 102
BOONE NC
28607-7828
US

IV. Provider business mailing address

PO BOX 3445
HICKORY NC
28603-3445
US

V. Phone/Fax

Practice location:
  • Phone: 888-626-2020
  • Fax: 828-345-0522
Mailing address:
  • Phone: 828-322-2050
  • Fax: 828-345-0522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2460
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2869
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618003293
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: