Individual
DIXIE LORAINE MCINTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1348 WALTON WAY STE 5100, AUGUSTA, GA 30901-5108
(706) 724-8611
(706) 724-6202
Mailing address
PO BOX 925, AUGUSTA, GA 30903-0925
(706) 724-8611
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
150973
GA
Other
Enumeration date
05/18/2020
Last updated
06/15/2020
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