MEDICARE: DR. MARCUS A BUTTON M.D.

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	207Q00000X	Family Medicine Physician	38223	CO

General Provider Information

NPI Number	:	1316943236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARCUS A BUTTON M.D.

Provider Business Mailing Address
First Line	:	715 S 9TH ST
Second Line	:
City	:	CANON CITY
State	:	CO
Zip	:	81212-4911
Country	:	US
Telephone Number	:	719-269-8820
Fax Number	:	719-204-0230

Provider Business Practice Location Address
First Line	:	715 S 9TH ST
Second Line	:
City	:	CANON CITY
State	:	CO
Zip	:	81212-4911
Country	:	US
Telephone Number	:	719-269-8820
Fax Number	:	719-204-0230

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

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	04/16/2013

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