Provider Demographics
NPI:1134702293
Name:BUTLER, DAVID LYNN (RPH)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:LYNN
Last Name:BUTLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1942 W 420 S
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-2867
Mailing Address - Country:US
Mailing Address - Phone:435-590-9855
Mailing Address - Fax:
Practice Address - Street 1:1942 W 420 S
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-2867
Practice Address - Country:US
Practice Address - Phone:435-590-9855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT144932-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist