Organization
MOUNTAIN CREEK SURGICAL CONSULTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY BRANDON BUTTE D.O. (PRESIDENT)
(928) 532-5463
Entity
Organization
Contact information
Practice address
5171 CUB LAKE RD, SUITE C390, SHOW LOW, AZ 85901-7888
(928) 532-5463
(928) 532-8474
Mailing address
5171 CUB LAKE RD STE C390, SHOW LOW, AZ 85901-7891
(928) 532-5463
(928) 532-8474
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4351
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
072852
—
AZ
01
—
AZ0427710
BCBS OF AZ
AZ
Enumeration date
03/24/2007
Last updated
02/24/2009
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