Provider Demographics
NPI:1144269739
Name:BUTTON FAMILY PRACTICE PC
Entity type:Organization
Organization Name:BUTTON FAMILY PRACTICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:A
Authorized Official - Last Name:BUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-269-8820
Mailing Address - Street 1:715 SOUTH 9TH STREET
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-4911
Mailing Address - Country:US
Mailing Address - Phone:719-269-8820
Mailing Address - Fax:719-204-0230
Practice Address - Street 1:715 SOUTH 9TH STREET
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-4911
Practice Address - Country:US
Practice Address - Phone:719-269-8820
Practice Address - Fax:719-204-0230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04321863Medicaid
CO063866Medicare Oscar/Certification