Provider Demographics
NPI:1427117217
Name:BUTCHER, JEFFERY P (RPH)
Entity type:Individual
Prefix:
First Name:JEFFERY
Middle Name:P
Last Name:BUTCHER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4929 RIDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41015-2011
Mailing Address - Country:US
Mailing Address - Phone:513-265-9016
Mailing Address - Fax:
Practice Address - Street 1:101 W PIKE ST
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:OH
Practice Address - Zip Code:45152-1107
Practice Address - Country:US
Practice Address - Phone:513-899-4074
Practice Address - Fax:513-899-3783
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-19022183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist