Provider Demographics
NPI:1194725812
Name:BUTLER, SCOTT E (PA-C)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:E
Last Name:BUTLER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 OLD GATESBURG RD
Mailing Address - Street 2:STE 100
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-2276
Mailing Address - Country:US
Mailing Address - Phone:814-237-3360
Mailing Address - Fax:814-237-2130
Practice Address - Street 1:1700 OLD GATESBURG RD
Practice Address - Street 2:STE 100
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-2276
Practice Address - Country:US
Practice Address - Phone:814-237-3360
Practice Address - Fax:814-237-2130
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2013-11-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA003280L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant