Basic Information
| Provider Information | |||||||||
| NPI: | 1346394988 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GENERAL & VASCULAR SURGEONS OF BUTLER CTY INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25 OFFICE PARK DRIVE | ||||||||
| Address2: | |||||||||
| City: | HAMILITON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5138441000 | ||||||||
| FaxNumber: | 5138963727 | ||||||||
| Practice Location | |||||||||
| Address1: | 25 OFFICE PARK DRIVE | ||||||||
| Address2: | |||||||||
| City: | HAMILITON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5138441000 | ||||||||
| FaxNumber: | 5138963727 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | REMADAS | ||||||||
| AuthorizedOfficialFirstName: | HOLENARSIPUR | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5138441000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | 2086S0129X | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
ID Information
| ID | Type | State | Issuer | Description | 20023532655452264740 | 05 | OH | MEDICAID | CD1997 | 01 | OH | RAILROAD MED CR | OTHER |