Provider Demographics
NPI:1760434922
Name:BUTTERS, DAVID ERNEST (MD, FRCS(C))
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ERNEST
Last Name:BUTTERS
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Gender:M
Credentials:MD, FRCS(C)
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Mailing Address - Street 1:1108 E PATTERSON ST
Mailing Address - Street 2:SUITE 9
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-4002
Mailing Address - Country:US
Mailing Address - Phone:660-627-5228
Mailing Address - Fax:814-373-2159
Practice Address - Street 1:1108 E PATTERSON ST
Practice Address - Street 2:SUITE 9
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-4002
Practice Address - Country:US
Practice Address - Phone:660-627-5228
Practice Address - Fax:814-373-2159
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2011-03-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2011004348208800000X, 2088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018607220002Medicaid
PAH51364Medicare UPIN
PA052546Medicare ID - Type Unspecified