Provider Demographics
NPI:1386253854
Name:BUTLER MEDICAL PROVIDERS
Entity type:Organization
Organization Name:BUTLER MEDICAL PROVIDERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO PHYSICIAN NETWORK
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:MADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-283-6666
Mailing Address - Street 1:PO BOX 1549
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16003-1549
Mailing Address - Country:US
Mailing Address - Phone:724-284-4060
Mailing Address - Fax:724-284-4144
Practice Address - Street 1:82 TOWN RUN RD
Practice Address - Street 2:
Practice Address - City:FAIRMOUNT CITY
Practice Address - State:PA
Practice Address - Zip Code:16224-1502
Practice Address - Country:US
Practice Address - Phone:814-275-1600
Practice Address - Fax:814-275-1610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-30
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4572039OtherBLUE SHIELD
PA001644521-0133Medicaid