Provider Demographics
NPI:1255403416
Name:BUTLER, ELIZABETH G (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:G
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 43100
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85733-3100
Mailing Address - Country:US
Mailing Address - Phone:520-296-9790
Mailing Address - Fax:520-296-0477
Practice Address - Street 1:403 W COOL DR STE 103
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-6551
Practice Address - Country:US
Practice Address - Phone:520-296-9790
Practice Address - Fax:520-296-0477
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ52257208G00000X
IN01065663A208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200909970Medicaid
AZZ190194Medicare PIN
INM400031562Medicare PIN