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Organization
SOUTHERN PINES FAMILY MEDICAL
Active
Organization
SOUTHERN PINES FAMILY MEDICAL
Active
Other names
Southern Pines Family Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN BUTT M D (MEMBER)
(985) 863-7100
Entity
Organization
Contact information
Practice address
64629 HIGHWAY 41, PEARL RIVER, LA 70452-3611
(985) 863-7100
Mailing address
PO BOX 1659, PEARL RIVER, LA 70452-1659
(985) 863-7100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
10/05/2006
Last updated
06/08/2011
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