Basic Information
| Provider Information | |||||||||
| NPI: | 1104995695 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUTLER | ||||||||
| FirstName: | SUZANNE | ||||||||
| MiddleName: | DOWDY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | DOWDY | ||||||||
| OtherFirstName: | SUZANNE | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 145 THOMPSON LN | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372112411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157810013 | ||||||||
| FaxNumber: | 6157810688 | ||||||||
| Practice Location | |||||||||
| Address1: | 145 THOMPSON LN | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372112411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157810013 | ||||||||
| FaxNumber: | 6157810688 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2006 | ||||||||
| LastUpdateDate: | 12/19/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | MD013620 | TN | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 02961 | 01 | TN | CIGNA | OTHER | 3009820 | 05 | TN | MEDICAID | 032611 | 01 | TN | VALUE OPTIONS | OTHER | 0021955 | 01 | TN | BCBST | OTHER |