Organization
BUTLER PHYSICIAN SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISHA C FALK (VICE PRESIDENT)
(337) 609-1221
Entity
Organization
Contact information
Practice address
3100 OAK GROVE RD, POPLAR BLUFF, MO 63901-1573
(573) 776-2000
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
208M00000X
Hospitalist Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982056545
—
MO
01
—
MA6339
MEDICARE OMISSOURI
MO
Enumeration date
07/07/2016
Last updated
05/01/2026
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