Basic Information
| Provider Information | |||||||||
| NPI: | 1225272040 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUTLER | ||||||||
| FirstName: | JOSHUA | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4010 MENDENHALL OAKS PKWY | ||||||||
| Address2: | |||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272658076 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368873195 | ||||||||
| FaxNumber: | 3368873194 | ||||||||
| Practice Location | |||||||||
| Address1: | 4010 MENDENHALL OAKS PKWY | ||||||||
| Address2: | |||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272658076 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368873195 | ||||||||
| FaxNumber: | 3368873194 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2009 | ||||||||
| LastUpdateDate: | 03/24/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 2013-00229 | NC | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.