Healthcare Provider Details

I. General information

NPI: 1649519778
Provider Name (Legal Business Name): BUTLER CANCER ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2013
Last Update Date: 02/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 TECHNOLOGY DR SUITE110
BUTLER PA
16001-1784
US

IV. Provider business mailing address

102 TECHNOLOGY DR SUITE110
BUTLER PA
16001-1784
US

V. Phone/Fax

Practice location:
  • Phone: 724-482-2679
  • Fax: 724-482-2542
Mailing address:
  • Phone: 724-482-2679
  • Fax: 724-482-2542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK T EHALT
Title or Position: SR.DIRECTOR
Credential:
Phone: 412-647-0943