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Individual

KENT 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) 347-6769
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
0526010
KS
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
3367
OK
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
R5N23
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
247988108
MO
01
9102
BLUE CROSS
MO
Enumeration date
01/18/2006
Last updated
04/07/2021
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