Provider Demographics
NPI:1881660637
Name:BUTLER, JUDY CLAYTON (DC)
Entity Type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:CLAYTON
Last Name:BUTLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 237
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:AR
Mailing Address - Zip Code:72562-0237
Mailing Address - Country:US
Mailing Address - Phone:870-799-3035
Mailing Address - Fax:870-799-3863
Practice Address - Street 1:140 W FRONT ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:AR
Practice Address - Zip Code:72562
Practice Address - Country:US
Practice Address - Phone:870-799-3035
Practice Address - Fax:870-799-3863
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1156111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR59682Medicare ID - Type Unspecified
AR5C238Medicare ID - Type UnspecifiedCLINIC PROVIDER NUMBER
ART79322Medicare UPIN