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General NPI Number Information
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NPI Number | 1215152020
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Entity Type | Organization
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Legal Business Name | BUTLER FAMILY MEDICAL CENTER INC
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 08/11/2017
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Provider Practice Location Address
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Address Line | 653 N TOWN CENTER DR SUITE 502
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City | LAS VEGAS
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State | NV
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Zip | 89144-0514
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Country | US
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Telephone | 702-242-4102
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Fax | 702-242-0177
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Provider Business Mailing Address
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Address Line | 653 N TOWN CENTER DR SUITE 502
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City | LAS VEGAS
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State | NV
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Zip | 89144-0514
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Country | US
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Telephone | 702-242-4102
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Fax | 702-242-0177
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RANDY H BUTLER
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Credential | MD
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Telephone | 702-242-4102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 6224
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License Number State | NV
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