Healthcare Provider Details

I. General information

NPI: 1881790095
Provider Name (Legal Business Name): AARON BUTCHER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 03/13/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3080 N 1700 E STE B
LAYTON UT
84040-8592
US

IV. Provider business mailing address

1660 W ANTELOPE DR STE 225
LAYTON UT
84041-1167
US

V. Phone/Fax

Practice location:
  • Phone: 801-825-6597
  • Fax: 888-770-2983
Mailing address:
  • Phone: 801-479-0312
  • Fax: 801-479-3364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number682
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberPA0317
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: