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NPI Code Detail

MEDICARE: JAMES AARON BUTZ CCSS

MEDICARE: JAMES AARON BUTZ CCSS
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
1172V00000XCommunity Health WorkerNM

General Provider Information

NPI Number : 1790586287
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES AARON BUTZ CCSS
Provider Business Mailing Address
First Line : 1419 S SANTA BARBARA ST
Second Line :
City : DEMING
State : NM
Zip : 88030-5361
Country : US
Telephone Number : 575-936-4227
Fax Number : 575-936-4658
Provider Business Practice Location Address
First Line : 1419 S SANTA BARBARA ST
Second Line :
City : DEMING
State : NM
Zip : 88030-5361
Country : US
Telephone Number : 575-936-4227
Fax Number : 575-936-4658
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2025
Last Update Date : 03/21/2025

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