Provider Demographics
NPI:1649245556
Name:BUTLER COUNTY SURGICAL GROUP, PA
Entity Type:Organization
Organization Name:BUTLER COUNTY SURGICAL GROUP, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:N
Authorized Official - Last Name:HAFFNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:316-321-5630
Mailing Address - Street 1:700 W CENTRAL AVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:EL DORADO
Mailing Address - State:KS
Mailing Address - Zip Code:67042-2184
Mailing Address - Country:US
Mailing Address - Phone:316-321-5630
Mailing Address - Fax:316-320-0244
Practice Address - Street 1:700 W CENTRAL AVE
Practice Address - Street 2:SUITE 111
Practice Address - City:EL DORADO
Practice Address - State:KS
Practice Address - Zip Code:67042-2184
Practice Address - Country:US
Practice Address - Phone:316-321-5630
Practice Address - Fax:316-320-0244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS003964OtherKS BLUE CROSS/BLUE SHIELD
KS003964Medicare ID - Type Unspecified