Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 11633905-0501 | UT |
N | 213ES0103X | Foot & Ankle Surgery | E 4727 | CA |
N | 213ES0103X | Foot & Ankle Surgery | EL 1582 | CA |
NPI | 1043428634 |
---|---|
Provider Name | Dr. Russell Jay Buttars |
First Address | Woods Cross, UT 84087-2361 |
Second Address | Logan, UT 84341-1796 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 30/07/2021 |