Healthcare Provider Details

I. General information

NPI: 1174559314
Provider Name (Legal Business Name): JENNIFER LYNN BUTTERFIELD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 07/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4750 E GALBRAITH RD SUITE #215
CINCINNATI OH
45236
US

IV. Provider business mailing address

1906 BLAKE AVE
GLENWOOD SPRINGS CO
81601-4227
US

V. Phone/Fax

Practice location:
  • Phone: 513-891-5610
  • Fax: 513-891-5638
Mailing address:
  • Phone: 970-384-7291
  • Fax: 970-384-7293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number35-074881
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: