Basic Information
| Provider Information | |||||||||
| NPI: | 1720307416 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUTLER | ||||||||
| FirstName: | KRISTEN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6701 AIRPORT BLVD STE A208 | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366083763 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2512663544 | ||||||||
| FaxNumber: | 2512663543 | ||||||||
| Practice Location | |||||||||
| Address1: | 6701 AIRPORT BLVD STE A208 | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366083763 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2512663544 | ||||||||
| FaxNumber: | 2512663543 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2010 | ||||||||
| LastUpdateDate: | 05/29/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 2016-00234 | NC | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0102X | MD.37419 | AL | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 208600000X | MD.37419 | AL | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.