Provider Demographics
NPI:1538155668
Name:BUTZ, BRETT LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:LYNN
Last Name:BUTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 W EAST AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-7201
Mailing Address - Country:US
Mailing Address - Phone:530-720-0176
Mailing Address - Fax:530-636-4517
Practice Address - Street 1:631 W EAST AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-7201
Practice Address - Country:US
Practice Address - Phone:530-720-0176
Practice Address - Fax:530-636-4517
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA052058207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA257726733BMedicaid
89452Medicare UPIN
GA05BDJSHMedicare ID - Type Unspecified