Provider Demographics
NPI:1669485652
Name:BUTLER, HENRY KING JR (MD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:KING
Last Name:BUTLER
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:515 HIGHLAND TERRACE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-2423
Mailing Address - Country:US
Mailing Address - Phone:615-890-0827
Mailing Address - Fax:615-890-0828
Practice Address - Street 1:515 HIGHLAND TERRACE
Practice Address - Street 2:SUITE A
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-2423
Practice Address - Country:US
Practice Address - Phone:615-890-0827
Practice Address - Fax:615-890-0828
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD0000004757207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3163069Medicaid
GAP00133922OtherRAILROAD MEDICARE
D70192Medicare UPIN
TN3163069Medicare ID - Type Unspecified