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Individual

DR. BRENDA L MCINTYRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
609 N TRENTON ST, RUSTON, LA 71270-3840
(318) 255-4112
(318) 251-8727
Mailing address
PO BOX 13082, RUSTON, LA 71273-3082
(318) 255-4112
(318) 251-8727

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD00042179
WA
208000000X
Pediatrics Physician
Primary
MD202561
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1343072
LA
Enumeration date
06/12/2006
Last updated
01/08/2017
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