Butler, Elliott

Butler, Elliott is an individual health care provider with primary practice located at 3400 Mcclure Bridge Rd B201, Duluth GA 30096-6675. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Butler, Elliott can be contacted via phone (678) 957-8801.

Contact Information

Primary practice address
3400 Mcclure Bridge Rd B201 Duluth GA 30096-6675
Phone: (678) 957-8801
Fax: (678) 957-8804
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 0044308 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 000870 Georgia

Profile Details

NPI number 1619959756
LBN Legal business name Butler, Elliott
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2005
Last updated Nov 24th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619959756 NPPES
Georgia Other 202I975412 MEDICARE PTAN
Georgia Other 1619959756 MEDICARE PTAN
Georgia MEDICAID 100002796A MEDICARE PTAN

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