Provider Demographics
NPI:1609190339
Name:BUTLER MEDICAL PROVIDERS
Entity Type:Organization
Organization Name:BUTLER MEDICAL PROVIDERS
Other - Org Name:BHS DERMATOLOGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE BMP REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:TEWKSBURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-284-4347
Mailing Address - Street 1:PO BOX 1549
Mailing Address - Street 2:SUITE 601
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16003-1549
Mailing Address - Country:US
Mailing Address - Phone:724-284-4060
Mailing Address - Fax:724-284-4144
Practice Address - Street 1:102 TECHNOLOGY DR
Practice Address - Street 2:SUITE 230
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-1784
Practice Address - Country:US
Practice Address - Phone:877-661-3376
Practice Address - Fax:724-482-2212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-24
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Multi-Specialty