Individual
DAVID BENJAMIN MCINTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4802 S 109TH EAST AVE, TULSA, OK 74146-5822
(918) 392-1400
Mailing address
1809 E 13TH ST, STE 100, TULSA, OK 74104-4431
(918) 392-1400
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3851
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200098040A
MEDICAID LEGACY
—
05
—
200098040A
—
OK
01
—
245702903
MEDICARE LEGACY
—
01
—
7757857
AETNA
—
01
—
P00407587
MEDICARE RAILROAD
—
Enumeration date
10/05/2006
Last updated
06/30/2016
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