Provider Demographics
NPI:1467020594
Name:BUTLER, CAITLIN MOORE (MD)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:MOORE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8240 NORTHCREEK DR STE 1400
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2379
Mailing Address - Country:US
Mailing Address - Phone:513-792-4700
Mailing Address - Fax:513-346-1396
Practice Address - Street 1:8240 NORTHCREEK DR STE 1400
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2379
Practice Address - Country:US
Practice Address - Phone:513-792-4700
Practice Address - Fax:513-346-1396
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.150311207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program