Provider Demographics
NPI:1518247220
Name:BUTTRAM, DAVID P (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:P
Last Name:BUTTRAM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 E LANGSFORD RD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-6323
Mailing Address - Country:US
Mailing Address - Phone:816-554-0403
Mailing Address - Fax:816-554-0877
Practice Address - Street 1:1801 E LANGSFORD RD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-6323
Practice Address - Country:US
Practice Address - Phone:816-554-0403
Practice Address - Fax:816-554-0877
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO042516183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist