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General NPI Number Information
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NPI Number | 1477507333
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Entity Type | Individual
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Provider Name | BRETT C. BUTLER MD
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Gender | Male
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 04/21/2020
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Provider Practice Location Address
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Address Line | 451 W LOCKE ST
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City | ASHDOWN
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State | AR
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Zip | 71822-3325
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Country | US
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Telephone | 870-898-5011
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Fax |
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Provider Business Mailing Address
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Address Line | 2107 BEECH ST
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City | TEXARKANA
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State | AR
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Zip | 71854-3509
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Country | US
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Telephone | 870-703-3385
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Fax | 870-330-0353
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 09578R
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | E-5775
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License Number State | AR
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