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NPI Code Detail

MEDICARE: CONNOR JAMES BUTZ PHYSICIAN ASSISTANT

MEDICARE: CONNOR JAMES BUTZ PHYSICIAN ASSISTANT
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
1363A00000XPhysician Assistant
2363AM0700XMedical Physician AssistantPA031613DC
3363AM0700XMedical Physician Assistant12729GA

General Provider Information

NPI Number : 1821654617
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONNOR JAMES BUTZ PHYSICIAN ASSISTANT
Provider Business Mailing Address
First Line : 659 AUBURN AVE NE STE 156
Second Line :
City : ATLANTA
State : GA
Zip : 30312-1976
Country : US
Telephone Number : 404-888-0228
Fax Number : 833-941-5100
Provider Business Practice Location Address
First Line : 659 AUBURN AVE NE STE 156
Second Line :
City : ATLANTA
State : GA
Zip : 30312-1976
Country : US
Telephone Number : 404-888-0228
Fax Number : 833-941-5100
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2019
Last Update Date : 12/18/2025

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Directions to “ CONNOR JAMES BUTZ PHYSICIAN ASSISTANT” Practice Location

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