Individual
SAMUEL W. BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3 E 18TH ST, SPENCER, IA 51301-3441
(712) 262-1589
(712) 262-3689
Mailing address
PO BOX 707, SPENCER, IA 51301-0707
(712) 262-1589
(712) 262-3689
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02135
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0198416
—
IA
01
—
05577
BLUE CROSS BLUE SHIELD
IA
Enumeration date
11/01/2006
Last updated
11/06/2007
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