Basic Information
| Provider Information | |||||||||
| NPI: | 1497889257 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUTLER | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | BENNETT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3647 SANCTUARY DR | ||||||||
| Address2: | |||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443331749 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3307803414 | ||||||||
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| Practice Location | |||||||||
| Address1: | 762 S CLEVELAND MASSILLON RD | ||||||||
| Address2: | |||||||||
| City: | FAIRLAWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443333024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306654100 | ||||||||
| FaxNumber: | 3306656748 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2007 | ||||||||
| LastUpdateDate: | 06/21/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | 35099390 | OH | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.