Provider Demographics
NPI:1871380717
Name:BUTLER, ROBERT EARL III
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:EARL
Last Name:BUTLER
Suffix:III
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 W HARRIS AVE
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-2935
Mailing Address - Country:US
Mailing Address - Phone:330-774-0983
Mailing Address - Fax:
Practice Address - Street 1:249 W HARRIS AVE
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-2935
Practice Address - Country:US
Practice Address - Phone:330-774-0983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker