Provider Demographics
NPI:1538460506
Name:BUTHORN, CHRISTOPHER FRANCIS (RPA-C)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:FRANCIS
Last Name:BUTHORN
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:35 GREEN POND RD STE C
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-2057
Mailing Address - Country:US
Mailing Address - Phone:973-625-0600
Mailing Address - Fax:
Practice Address - Street 1:5046 HIGHWAY 17 BYP S STE 103
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588
Practice Address - Country:US
Practice Address - Phone:843-668-4104
Practice Address - Fax:843-668-4108
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-08
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC2531363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical