Individual
EMILY KATHRYN BUTTKUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
100 PHYSICIANS WAY STE 110, LEBANON, TN 37090-8107
(615) 547-6700
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 494-3071
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA0000005515
TN
363AS0400X
Surgical Physician Assistant
Primary
PA5515
TN
Other
Enumeration date
05/04/2023
Last updated
09/08/2023
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