Provider Demographics
NPI:1174558860
Name:BUTLER, CATHERINE E (MD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:E
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 1ST ST NW
Mailing Address - Street 2:
Mailing Address - City:BRITT
Mailing Address - State:IA
Mailing Address - Zip Code:50423-1227
Mailing Address - Country:US
Mailing Address - Phone:641-843-5050
Mailing Address - Fax:641-843-5051
Practice Address - Street 1:532 1ST ST NW
Practice Address - Street 2:
Practice Address - City:BRITT
Practice Address - State:IA
Practice Address - Zip Code:50423-1227
Practice Address - Country:US
Practice Address - Phone:641-843-5050
Practice Address - Fax:641-843-5051
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA29072207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA5092163Medicaid
IA15171OtherWELLMARK - WESLEY CLINIC
IA4092163Medicaid
IA18053OtherWELLMARK -BRITT CLINIC
IA15014Medicare ID - Type UnspecifiedBRITT MEDICAL CLINIC
IA4092163Medicaid