Provider Demographics
NPI:1598890972
Name:GEORGE C BUTTON MD PA
Entity Type:Organization
Organization Name:GEORGE C BUTTON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:BUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-564-1111
Mailing Address - Street 1:2780 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1424
Mailing Address - Country:US
Mailing Address - Phone:954-564-1111
Mailing Address - Fax:954-564-0126
Practice Address - Street 1:2780 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1424
Practice Address - Country:US
Practice Address - Phone:954-564-1111
Practice Address - Fax:954-564-0126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME22217171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8632Medicare PIN
FLD27143Medicare UPIN