Individual
CHARLES RODNEY BUTLER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
100 FREEMAN DR, SAINT PETER, MN 56082-3504
(507) 931-7125
(507) 931-7126
Mailing address
100 FREEMAN DR, SAINT PETER, MN 56082-3504
(507) 985-2111
(507) 931-7126
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39742
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417058066
NPI
—
01
—
228G3BU
BLUE CROSS/BLUE SHIELD
MN
05
—
672025100
—
MN
Enumeration date
09/26/2006
Last updated
05/14/2014
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