Individual
DR. JONATHAN TY BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
12200 WARWICK BLVD STE 110, RIVERSIDE NEUROLOGY SPECIALISTS, NEWPORT NEWS, VA 23601-2344
(757) 534-5100
(757) 534-5395
Mailing address
856 J CLYDE MORRIS BLVD STE A, RIVERSIDE MEDICAL GROUP, NEWPORT NEWS, VA 23601-1318
(757) 594-4006
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
0101260074
VA
Other
Enumeration date
04/11/2011
Last updated
08/08/2016
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