MEDICARE: J DENNIS BUTLER CRNP

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	363LA2200X	Adult Health Nurse Practitioner	1-032598	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	500021680	OTHER	AL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	051505975	OTHER	AL	BLUE CROSS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437179553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	J DENNIS BUTLER CRNP

Provider Business Mailing Address
First Line	:	1919 OXMOOR RD
Second Line	:	STE 276
City	:	HOMEWOOD
State	:	AL
Zip	:	35209-3502
Country	:	US
Telephone Number	:	205-879-8294
Fax Number	:	205-879-8259

Provider Business Practice Location Address
First Line	:	4704 CAHABA RIVER RD
Second Line	:	SUITE 101D
City	:	BIRMINGHAM
State	:	AL
Zip	:	35243-2344
Country	:	US
Telephone Number	:	205-739-2266
Fax Number	:	205-739-2335

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

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	03/14/2017

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Directions to “ J DENNIS BUTLER CRNP” Practice Location

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