Provider Demographics
NPI:1538214721
Name:BUTLER, ROBERT HOYT (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:HOYT
Last Name:BUTLER
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:PO BOX 5418
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27204-5418
Mailing Address - Country:US
Mailing Address - Phone:336-625-0305
Mailing Address - Fax:336-625-9941
Practice Address - Street 1:700 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5304
Practice Address - Country:US
Practice Address - Phone:336-625-0305
Practice Address - Fax:336-625-9941
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26801207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8920458Medicaid
C83084Medicare UPIN
NCNC1945AMedicare PIN
205188AMedicare ID - Type Unspecified