Provider Demographics
NPI:1437757309
Name:BUTIKOFER, AUSTIN JAMES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:JAMES
Last Name:BUTIKOFER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 25TH ST SE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-5576
Mailing Address - Country:US
Mailing Address - Phone:507-292-1475
Mailing Address - Fax:507-292-1740
Practice Address - Street 1:25 25TH ST SE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-5576
Practice Address - Country:US
Practice Address - Phone:507-292-1475
Practice Address - Fax:507-292-1740
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN123903183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist