Provider Demographics
NPI:1134140643
Name:BUTLER, DONNIE EUGENE JR (DC)
Entity type:Individual
Prefix:DR
First Name:DONNIE
Middle Name:EUGENE
Last Name:BUTLER
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 NORTH SLAPPEY BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-1413
Mailing Address - Country:US
Mailing Address - Phone:229-439-1950
Mailing Address - Fax:229-439-1951
Practice Address - Street 1:701 NORTH SLAPPEY BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1413
Practice Address - Country:US
Practice Address - Phone:229-439-1950
Practice Address - Fax:229-439-1951
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006371111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I351962OtherMEDICARE ID
GA201291746OtherFED TAX ID
GAU85098Medicare UPIN