Individual
DR. EDWIN EUGENE BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1320 BISHOP RANDALL DR, DEPARTMENT OF RADIOLOGY, LANDER, WY 82520-3939
(307) 335-6251
(307) 335-6467
Mailing address
2265 E SUNNYSIDE RD, IDAHO FALLS, ID 83404-7598
(208) 542-5000
(208) 542-5151
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
78054
MT
2085R0202X
Diagnostic Radiology Physician
Primary
9415A
WY
2085R0202X
Diagnostic Radiology Physician
M-14819
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136028100
—
WY
Enumeration date
10/23/2008
Last updated
03/04/2020
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