Provider Demographics
NPI:1407392574
Name:BUTLER, FRANCIS JR
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:
Last Name:BUTLER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 PEPPER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SUSAN
Mailing Address - State:VA
Mailing Address - Zip Code:23163-2140
Mailing Address - Country:US
Mailing Address - Phone:804-832-2839
Mailing Address - Fax:
Practice Address - Street 1:311 PEPPER CREEK RD
Practice Address - Street 2:
Practice Address - City:SUSAN
Practice Address - State:VA
Practice Address - Zip Code:23163-2140
Practice Address - Country:US
Practice Address - Phone:804-832-2839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4MTTOtherLOGISTICARE