Provider Demographics
NPI:1386637304
Name:BUTLER, JOHN ROBIN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ROBIN
Last Name:BUTLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 548
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:AR
Mailing Address - Zip Code:71754
Mailing Address - Country:US
Mailing Address - Phone:870-234-2225
Mailing Address - Fax:870-234-4822
Practice Address - Street 1:624 N DUDNEY RD
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753-3050
Practice Address - Country:US
Practice Address - Phone:870-234-2225
Practice Address - Fax:870-234-4822
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2017-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1229111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR59782OtherBLUE CROSS BLUE SHIELD
AR118286718Medicaid
AR350041218OtherRAILROAD RETIREMENT MEDIC
AR350041218OtherRAILROAD RETIREMENT MEDIC
ARU08364Medicare UPIN