Basic Information
| Provider Information | |||||||||
| NPI: | 1427285071 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUTLER | ||||||||
| FirstName: | NICHOLAS | ||||||||
| MiddleName: | RYAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 HAWKINS DR | ||||||||
| Address2: | DEPARTMENT OF FAMILY MEDICINE | ||||||||
| City: | IOWA CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 522421009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3194672000 | ||||||||
| FaxNumber: | 3194672814 | ||||||||
| Practice Location | |||||||||
| Address1: | 920 E 2ND AVE STE 201B | ||||||||
| Address2: | |||||||||
| City: | CORALVILLE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 522412225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3194672000 | ||||||||
| FaxNumber: | 3194672814 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2009 | ||||||||
| LastUpdateDate: | 08/29/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QG0300X | MD-40314 | IA | N | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine | 207Q00000X | 125-056824 | IL | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | MD-40314 | IA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.