Provider Demographics
NPI:1831156835
Name:BUTLER, CAROLYN P (MD)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:P
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:N19W23993 RIDGEVIEW PKWY W STE 100
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1031
Mailing Address - Country:US
Mailing Address - Phone:262-547-3352
Mailing Address - Fax:262-547-9142
Practice Address - Street 1:N19W23993 RIDGEVIEW PKWY W STE 100
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1031
Practice Address - Country:US
Practice Address - Phone:262-547-3352
Practice Address - Fax:262-547-9142
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2023-12-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI37351-020207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32256900OtherABRI
WI391101335OtherWI PHYS SERVICES WPS
WI391101335OtherWI HEALTH INS RISK PROG
WI0800099OtherUNITED HEALTHCARE
WI32256900Medicaid
WI180026829OtherRAILROAD MEDICARE
WI822601OtherVIPA
WI4509471OtherAETNA
WI747042OtherMOHAWK
WI103432OtherHEALTH ALLIANCE
WI32256900OtherMANAGED HEALTH SERVICES