Individual
DR. KELLY JO BUTNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-8211
(802) 847-9644
Mailing address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-8211
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
042-0010437
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02365268
—
NY
05
—
1008963
—
VT
Enumeration date
07/08/2006
Last updated
10/08/2010
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