Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 5001709 | WI |
Y | 213EG0000X | General Practice | 5001709 | WI |
NPI | 1003837238 |
---|---|
Provider Name | Anthony Robert Butchert |
First Address | Eau Claire, WI 54701-3426 |
Second Address | Eau Claire, WI 54701-3426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2006 |
Last Update Date | 24/08/2016 |