Provider Demographics
NPI:1689754822
Name:BUTLER, LEON EVERETT JR (MD)
Entity Type:Individual
Prefix:DR
First Name:LEON
Middle Name:EVERETT
Last Name:BUTLER
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:16605 CHESTNUT GLEN PL
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-6121
Mailing Address - Country:US
Mailing Address - Phone:502-709-0430
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:16605 CHESTNUT GLEN PL
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-6121
Practice Address - Country:US
Practice Address - Phone:502-709-0430
Practice Address - Fax:502-272-5116
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2024-03-13
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Provider Licenses
StateLicense IDTaxonomies
MI4301038306207R00000X
IN01068145A207R00000X
KY42017207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100070770Medicaid
KYP00773828OtherRAILROAD MEDICARE- NORTON HOUSE CALLS
KY50022561OtherPASSPORT- NORTON HOUSE CALLS
KY369888000OtherPASSPORT ADVANTAGE- NORTON HOUSE CALLS
KY00533104OtherMEDICARE- NORTON HOUSE CALLS