NPI 1043428634 · live from the CMS NPI Registry
Russell Jay Buttars, DPM
Podiatrist, Foot & Ankle Surgery in Logan, UT. National Provider Identifier 1043428634, active.
NPI record
| NPI | 1043428634 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Foot & Ankle Surgery 213ES0103X |
| Practice location | 2310 N 400 E Ste A, Logan, UT 84341 |
| Practice phone | 435-787-2000 |
| Mailing address | 2561 S 1560 W Ste B, Woods Cross, UT 84087 |
| Enumerated | May 18, 2007 |
| Last updated | July 30, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery | 213ES0103X | E 4727 (CA) |
| Podiatrist, Foot & Ankle Surgery | 213ES0103X | el 1582 (CA) |
| Podiatrist, Foot & Ankle Surgery primary | 213ES0103X | 11633905-0501 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.