Provider Demographics
NPI:1881732899
Name:BUTTERBAUGH, BARTON WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:BARTON
Middle Name:WILLIAM
Last Name:BUTTERBAUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13984
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85267-3984
Mailing Address - Country:US
Mailing Address - Phone:480-951-4888
Mailing Address - Fax:480-951-4262
Practice Address - Street 1:1200 W MOHAVE RD
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:AZ
Practice Address - Zip Code:85344-6349
Practice Address - Country:US
Practice Address - Phone:928-669-7380
Practice Address - Fax:928-669-7371
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14268207Q00000X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ278756Medicaid
AZ278756Medicaid
AZ76301Medicare ID - Type UnspecifiedBARTON W. BUTTERBAUGH, MD
AZ76300Medicare ID - Type UnspecifiedSONORAN EMERG. ASSOC.