Individual
BRADLEY S BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1968 PEACHTREE RD NW, ATLANTA, GA 30309
(404) 605-3247
(404) 609-6645
Mailing address
PO BOX 491028, LAWRENCEVILLE, GA 30049
(404) 605-3247
(404) 609-6645
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
054980
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
524899677C
—
GA
Enumeration date
03/14/2006
Last updated
02/12/2009
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