Provider Demographics
NPI:1619747078
Name:BUTLER & COMMANDER HEALTH LLC
Entity Type:Organization
Organization Name:BUTLER & COMMANDER HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:COMMANDER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:318-210-7573
Mailing Address - Street 1:18388 S LAMONS RD
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-1242
Mailing Address - Country:US
Mailing Address - Phone:318-210-7573
Mailing Address - Fax:
Practice Address - Street 1:18388 S LAMONS RD
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-1242
Practice Address - Country:US
Practice Address - Phone:318-210-7573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty