| Mr Greene Butler, MD | |
|
1200 S Farmerville St, Ruston, LA 71270-5941 | |
| (318) 255-3690 | |
| Not Available |
| Full Name | Mr Greene Butler |
|---|---|
| Gender | Male |
| Speciality | Surgery |
| Location | 1200 S Farmerville St, Ruston, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619947629 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 16316 (Louisiana) | Primary |
| Entity Name | Lasalle Parish Hospital Service District #1 |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184815466 PECOS PAC ID: 6709781545 Enrollment ID: O20040408000438 |
| Entity Name | Green Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831178755 PECOS PAC ID: 4789668831 Enrollment ID: O20040616000177 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Greene Butler, MD 1200 S Farmerville St, Ruston, LA 71270-5941 Ph: (318) 255-3690 | Mr Greene Butler, MD 1200 S Farmerville St, Ruston, LA 71270-5941 Ph: (318) 255-3690 |
Mr. Derek R Mcclusky, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1200 S Farmerville St, Ruston, LA 71270 Phone: 318-255-3690 | |
Dr. Cody Blackwelder, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1200 S Farmerville St, Ruston, LA 71270 Phone: 318-255-3690 | |
Kerry Wayne Byrnes, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1200 S Farmerville St, Ruston, LA 71270 Phone: 318-255-9630 |