Butler, Walter Blake

Butler, Walter Blake is an individual health care provider with primary practice located at 100 W 4Th St Suite 310, Cookeville TN 38501-2448. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Butler, Walter Blake can be contacted via phone (931) 528-7877.

Contact Information

Primary practice address
100 W 4Th St Suite 310 Cookeville TN 38501-2448
Phone: (931) 528-7877
Fax: (931) 526-3261
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 39755 Tennessee

Profile Details

NPI number 1326025354
LBN Legal business name Butler, Walter Blake
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 30th, 2005
Last updated Jul 13th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326025354 NPPES
Kentucky MEDICAID 64125958
Kentucky Other P00362930
Kentucky MEDICAID 3332331
Kentucky Other 4106662

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