MR. WANDLE KEITH BUTLER (PAC) – Physician Assistant, NPI 1689897209
Excluded from federal healthcare programs (Medicare/Medicaid)
This provider is listed on the OIG List of Excluded Individuals/Entities (LEIE). Exclusion effective: 2023-05-18. Reason: Felony conviction relating to controlled substance (mandatory; min. 5 years).
Physician Assistant
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MR. WANDLE KEITH BUTLER (PAC)
410 SHIRLEY AVE
DOUGLAS, GA 315332002
Phone: (912) 260-1206
Fax: (912) 383-7820
Type: Mailing
306 WESTSIDE DR
DOUGLAS, GA 315333530
Phone: (912) 383-7826
Fax: (912) 383-7299
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 31533)
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