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Individual

ALLEN P BUTLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2406 LIGHTHOUSE MANOR DR, GAINESVILLE, GA 30501-7401
(770) 536-4352
(770) 532-8165
Mailing address
2406 LIGHTHOUSE MANOR DR, GAINESVILLE, GA 30501-7401
(770) 536-4352
(770) 532-8165

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
14873R
LA
207Y00000X
Otolaryngology Physician
Primary
52260
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1151262
LA
Enumeration date
07/07/2005
Last updated
11/02/2010
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