Provider Demographics
NPI:1174559314
Name:BUTTERFIELD, JENNIFER LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LYNN
Last Name:BUTTERFIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1906 BLAKE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-4227
Mailing Address - Country:US
Mailing Address - Phone:970-384-7291
Mailing Address - Fax:970-384-7293
Practice Address - Street 1:4750 E GALBRAITH RD
Practice Address - Street 2:SUITE #215
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236
Practice Address - Country:US
Practice Address - Phone:513-891-5610
Practice Address - Fax:513-891-5638
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35-074881208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2262340Medicaid
OH4070085Medicare PIN
OH2262340Medicaid