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General NPI Number Information
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NPI Number | 1609929785
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Entity Type | Organization
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Legal Business Name | BUTLER-ABSHIRE MEDICAL CLINIC, APMC
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 05/14/2010
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Provider Practice Location Address
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Address Line | 926 FRANCES DR
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City | HAYNESVILLE
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State | LA
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Zip | 71038-6100
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Country | US
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Telephone | 318-624-0554
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Fax | 318-624-3782
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Provider Business Mailing Address
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Address Line | 926 FRANCES DR
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City | HAYNESVILLE
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State | LA
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Zip | 71038-6100
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Country | US
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Telephone | 318-624-0554
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Fax | 318-624-3782
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Authorized Official
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Title or Position | SECRETARY TREASURER
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Name | DR. SAMUEL K ABSHIRE
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Credential | M.D.
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Telephone | 318-624-0554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 1480
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License Number State | LA
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