Butzon, Cory C

Butzon, Cory C is an individual health care provider with primary practice located at 1514 Vernon Rd , Lagrange GA 30240-4131. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Butzon, Cory C can be contacted via phone (706) 812-2369.

Contact Information

Primary practice address
1514 Vernon Rd Lagrange GA 30240-4131
Phone: (706) 812-2369
Fax: (706) 845-3194
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 003630 Georgia
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 068124 Georgia

Profile Details

NPI number 1659509685
LBN Legal business name Butzon, Cory C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2009
Last updated Oct 31st, 2019 - about 5 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 1659509685 NPPES
Georgia MEDICAID 003125382A

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