Individual
DR. JEROME MACK BUTLER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2525 COURT DR, GASTONIA, NC 28054-2140
(704) 834-2944
Mailing address
200 QUEENS RD, SUITE 400, CHARLOTTE, NC 28204-3253
(704) 333-7376
(704) 333-3397
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
2006-01706
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
205202
MEDCOST
NC
05
—
5908709
—
NC
05
—
N01706
—
SC
Enumeration date
01/02/2008
Last updated
07/13/2018
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