Healthcare Provider Details

I. General information

NPI: 1932337664
Provider Name (Legal Business Name): WALTER MURRAY BUTLER D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 03/14/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 POPLAR AVE STE 190
MEMPHIS TN
38119-4810
US

IV. Provider business mailing address

8055 CLUB PKWY
CORDOVA TN
38016-5967
US

V. Phone/Fax

Practice location:
  • Phone: 901-309-7700
  • Fax: 901-507-3297
Mailing address:
  • Phone: 901-309-7700
  • Fax: 901-507-3297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number728
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number80218
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: