Jacob Larry Butler, is a
Occupational Therapist based in Provo, Utah. Jacob Larry Butler is licensed to practice in Utah (license number 11351103-4201) and his current practice location is
1034 N 500 W, Provo, Utah. He can be reached at his office (for appointments etc.) via phone at
(801) 357-7850.
NPI number for Jacob Larry Butler is 1972908762 and his current mailing address is 3613 E Golden Eagle Rd, Eagle Mountain, Utah. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1972908762.
Healthcare Provider's Profile
Full Name | Jacob Larry Butler |
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Gender | Male |
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Speciality | Occupational Therapist |
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Location | 1034 N 500 W, Provo, Utah |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1972908762
- Provider Enumeration Date: 10/23/2014
- Last Update Date: 11/08/2021
Medical Identifiers
Medical identifiers for Jacob Larry Butler such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1972908762 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101Y00000X | Counselor | (* (Not Available)) | Secondary |
225X00000X | Occupational Therapist | 11351103-4201 (Utah) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacob Larry Butler is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jacob Larry Butler, 3613 E Golden Eagle Rd, Eagle Mountain, UT 84005-3866 Ph: (435) 650-7021 | Jacob Larry Butler, 1034 N 500 W, Provo, UT 84604-3337 Ph: (801) 357-7850 |
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