Provider Demographics
NPI:1205838398
Name:BUTLER, THOMAS E JR (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:BUTLER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4727 E CAMP LOWELL DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1256
Mailing Address - Country:US
Mailing Address - Phone:520-290-4263
Mailing Address - Fax:520-323-2716
Practice Address - Street 1:4727 E CAMP LOWELL DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1256
Practice Address - Country:US
Practice Address - Phone:520-290-4263
Practice Address - Fax:520-323-2716
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ22515207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ101167OtherUNITED HEALTH CARE
AZ98227OtherPACIFICARE
AZAZ0820900OtherBCBS
AZ168098Medicaid
AZ35614OtherHEALTH NET
AZ101167OtherUNITED HEALTH CARE
AZ35614OtherHEALTH NET