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General NPI Number Information
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NPI Number | 1760839179
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Entity Type | Organization
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Legal Business Name | MATTHEW A. BUTLER, MD, PA
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Dates
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Enumeration Date | 05/17/2016
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Last Update Date | 04/29/2017
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Provider Practice Location Address
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Address Line | 9350 E 35TH ST N SUITE 101
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City | WICHITA
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State | KS
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Zip | 67226-2019
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Country | US
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Telephone | 316-265-1308
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Fax | 316-265-4480
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Provider Business Mailing Address
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Address Line | PO BOX 47669
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City | WICHITA
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State | KS
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Zip | 67201-7669
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Country | US
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Telephone | 316-712-9235
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Fax | 316-219-4141
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Authorized Official
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Title or Position | OWNER
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Name | DR. MATTHEW A BUTLER
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Credential | MD
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Telephone | 316-265-1308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 04-36315
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License Number State | KS
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