Provider Demographics
NPI:1285716605
Name:BUTTERMAN, JAY M (DO)
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:M
Last Name:BUTTERMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:752 N MAIN ST UNIT 658
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-3264
Mailing Address - Country:US
Mailing Address - Phone:817-225-4334
Mailing Address - Fax:817-225-4338
Practice Address - Street 1:752 N MAIN ST UNIT 658
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-3264
Practice Address - Country:US
Practice Address - Phone:817-225-4334
Practice Address - Fax:817-225-4338
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ16262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry