Individual
JAMES RUSSELL BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
545 BARNHILL DR, EMERSON HALL 202, INDIANAPOLIS, IN 46202-5112
(317) 274-5771
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01077045A
IN
208600000X
Surgery Physician
11016293A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
233690135
MEDICARE PTAN
IN
05
—
300055010
—
IN
Enumeration date
07/22/2011
Last updated
02/21/2024
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