Provider Demographics
NPI:1447319348
Name:BUTLER, HENRY EMERSON III (MD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:EMERSON
Last Name:BUTLER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 ELIZABETH PL
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23704-2408
Mailing Address - Country:US
Mailing Address - Phone:757-397-7283
Mailing Address - Fax:
Practice Address - Street 1:533 ELIZABETH PL
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-2408
Practice Address - Country:US
Practice Address - Phone:757-397-7283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17701208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery