Individual
MELISSA J MCINTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
510 PETER PAN RD, INDEPENDENCE, KS 67301-7300
(620) 577-4310
(620) 577-4312
Mailing address
PO BOX 736, PARSONS, KS 67357-0736
(620) 820-5428
(620) 820-5821
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04-29443
KS
208000000X
Pediatrics Physician
04-29443
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100229360A
OKLAHOMA MEDICAID
OK
05
—
100412310A
—
KS
01
—
101724
BLUE CROSS BLUE SHIELD
KS
01
—
110236310
TRAVELERS MEDICARE
KS
Enumeration date
07/25/2006
Last updated
02/19/2018
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