ELLIOTT BUTLER PA-C NPI 1619959756

NPI Information

  • NPI: 1619959756
  • Provider Name: ELLIOTT BUTLER, PA-C
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3400 MCCLURE BRIDGE RD
    B201
    DULUTH, GA
    ZIP 30096
  • Phone: (678) 957-8801

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NPI Details

Elliott Butler, PA-C is a surgical physician assistant in Duluth, GA. Elliott Butler, PA-C NPI is 1619959756. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3400 MCCLURE BRIDGE RD
B201
DULUTH, GA
ZIP 30096-675
Phone: (678) 957-8801
Fax: (678) 957-8804

The NPI 1619959756 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 11/15/2005 and was last updated on 11/24/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedical0044308GEORGIANo
2363AS0400XPhysician AssistantSurgical000870GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
197WCDFJMEDICARE ID-TYPE UNSPECIFIEDGEORGIA
21619959756OTHERGEORGIANATIONAL PROVIDER IDENTIFIER
3P69595MEDICARE UPINGEORGIA
4202I975412OTHERGEORGIAMEDICARE PTAN
5100002796AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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