Individual
MR. MICHAEL J MCINTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9001 SUMMA AVE, BATON ROUGE, LA 70809-3726
(225) 761-5200
(225) 761-5558
Mailing address
9001 SUMMA AVE, BATON ROUGE, LA 70809-3726
(225) 761-5200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
A10551.RX
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780138
—
LA
Enumeration date
07/25/2006
Last updated
12/13/2007
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