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MR. WANDLE KEITH BUTLER PAC NPI 1689897209


NPI Information

NPI: 1689897209
Provider Name: MR. WANDLE KEITH BUTLER, PAC
Classification: Physician Assistant - 363A00000X
Entity Type: Individual
Address:
306 WESTSIDE DR
DOUGLAS, GA
ZIP 31533
Phone: (912) 383-7826
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MR. Wandle Keith Butler, PAC is a physician assistant in Douglas, GA. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. MR. Wandle Keith Butler, PAC NPI is 1689897209. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

306 WESTSIDE DR
DOUGLAS, GA
ZIP 31533-530
Phone: (912) 383-7826
Fax: (912) 383-7299

The enumeration date for this NPI number is 4/11/2007 and was last updated on 11/9/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician Assistant003196GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1202I976980MEDICARE PINGEORGIA
2100000954CMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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