MEDICARE: JAY C BUTLER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	4143	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316132434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAY C BUTLER MD

Provider Business Mailing Address
First Line	:	4055 TUDOR CENTRE DR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5932
Country	:	US
Telephone Number	:	907-563-2662
Fax Number	:

Provider Business Practice Location Address
First Line	:	4055 TUDOR CENTRE DR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5932
Country	:	US
Telephone Number	:	907-563-2662
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2007
Last Update Date	:	09/23/2008

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