Individual
LARRY DOUGLAS MCINTIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1331 W 32ND ST, JOPLIN, MO 64804
(417) 347-6767
(417) 347-3170
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-6767
(417) 347-3170
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
0526146
KS
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
22386
OK
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
33563
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
241195528
—
MO
01
—
9054
BLUE CROSS
MO
Enumeration date
01/18/2006
Last updated
03/08/2011
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