Individual
KELLEY M. MCINTYRE
Active
Individual
KELLEY M. MCINTYRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36930
KY
207RB0002X
Obesity Medicine (Internal Medicine) Physician
36930
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000225552
ANTHEM / NCMA
KY
01
—
000023029E
HUMANA / NCMA
KY
01
—
012818
SIHO / NCMA
KY
01
—
110235754
RAILROAD MEDICARE
KY
01
—
1165398
PASSORT / NCM A
KY
05
—
200532250
—
IN
01
—
2439944000
PASSPORT ADVANTAGE
KY
05
—
64048663
—
KY
Enumeration date
04/19/2006
Last updated
05/19/2022
Update your record
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