Provider Demographics
NPI:1265644967
Name:BUTLER, PARIS D (MD)
Entity Type:Individual
Prefix:
First Name:PARIS
Middle Name:D
Last Name:BUTLER
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3400 CIVIC CENTER BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5127
Mailing Address - Country:US
Mailing Address - Phone:215-662-7300
Mailing Address - Fax:215-615-3397
Practice Address - Street 1:3400 CIVIC CENTER BLVD FL 4
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5127
Practice Address - Country:US
Practice Address - Phone:215-662-7300
Practice Address - Fax:215-615-3397
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2022-04-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD445469208600000X, 208200000X
CT70065208600000X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery