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NPI Code Detail

MEDICARE: MS. DENNIS J BUTLER PHD

MEDICARE: MS. DENNIS J BUTLER PHD
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
1103TF0000XFamily PsychologistWI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2002000139XOTHERHUMANA

General Provider Information

NPI Number : 1801841531
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DENNIS J BUTLER PHD
Provider Business Mailing Address
First Line : 1121 E NORTH AVE
Second Line : COLUMBIA-ST. MARY'S FAMILY PRACTICE
City : MILWAUKEE
State : WI
Zip : 53212-3515
Country : US
Telephone Number : 414-267-6533
Fax Number : 414-267-3892
Provider Business Practice Location Address
First Line : 1121 E NORTH AVE
Second Line : COLUMBIA-ST. MARY'S FAMILY PRACTICE
City : MILWAUKEE
State : WI
Zip : 53212-3515
Country : US
Telephone Number : 414-267-6533
Fax Number : 414-267-3892
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2006
Last Update Date : 02/11/2013

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