Individual
MR. MARVIN LYNELL MCINTOSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1121 QUINDARO BLVD, KANSAS CITY, KS 66104-5331
(913) 233-1733
(913) 233-0055
Mailing address
1121 QUINDARO BLVD, KANSAS CITY, KS 66104-5331
(913) 233-1733
(913) 233-0055
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0428352
KS
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
04-28352
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200006440A
—
KS
05
—
200006440D
—
KS
Enumeration date
09/20/2006
Last updated
06/05/2012
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