Provider Demographics
NPI:1841279270
Name:BUTLER, MARGARET A (MD)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:A
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:A
Other - Last Name:PENILLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5032 S ASH AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-6842
Mailing Address - Country:US
Mailing Address - Phone:480-820-1919
Mailing Address - Fax:480-304-9047
Practice Address - Street 1:5032 S ASH AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-6842
Practice Address - Country:US
Practice Address - Phone:480-820-1919
Practice Address - Fax:480-304-9047
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ22499208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ170217Medicaid
AZF84925Medicare UPIN
AZ73587Medicare UPIN