Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 023916 | GA |
Y | 207VE0102X | Reproductive Endocrinologist | 023916 | GA |
NPI | 1255430906 |
---|---|
Provider Name | William Butler |
First Address | Macon, GA 31210-1822 |
Second Address | Macon, GA 31210-1822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 13/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000285436E | (05) | GA |
D76917 | (02) | GA |