Marvin L Mcintosh (NPI# 1417054362, PAC ID# 4688642812) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY PRACTICE.
Nation Provider ID (NPI) | 1417054362 |
PAC ID by PECOS | 4688642812 |
Professional Enrollment ID | I20040924000115 |
Full Name | Marvin L Mcintosh |
Organization Legal Name | COMMUNITY HOUSE OF WELLNESS |
Address |
1121 Quindaro Blvd Kansas City KS 66104-5331 |
Phone Number | 9132331733 |
Gender | M |
Credential | MD |
Medical School | UNIVERSITY OF KANSAS SCHOOL OF MEDICINE |
Graduation Year | 1975 |
Primary Specialty | FAMILY PRACTICE |
Group Practice PAC ID | 8224220983 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
170146 | PROVIDENCE MEDICAL CENTER |
Address | Phone | Organization |
---|---|---|
1121 Quindaro Blvd, Kansas City, KS 66104-5331 | 9132331733 | COMMUNITY HOUSE OF WELLNESS |
Organization Legal Name | COMMUNITY HOUSE OF WELLNESS |
Physicians | 1 |
Street Address |
1121 QUINDARO BLVD |
City | KANSAS CITY |
State | KS |
Zip | 66104-5331 |
Name | Specialty | Organization | Address |
---|---|---|---|
Srinath Tadakamalla | Geriatric Medicine | Complete Health Care Services Pa | 3231 N 61st St, Life Care Ctr of Kansas City, Kansas City, KS 66104-1415 |
George J Bures Jr. | Family Medicine | Swope Health Services | 6013 Leavenworth Rd, Kansas City, KS 66104-1436 |
Kylie I Gaustad | Nurse Practitioner | Swope Health Services | 6013 Leavenworth Rd, Kansas City, KS 66104-1436 |
Brady W Hanson | Family Medicine | Swope Health Services | 6013 Leavenworth Rd, Kansas City, KS 66104-1436 |
City | KANSAS CITY |
Zip Code | 66104 |
Specialty | FAMILY PRACTICE |
City + Specialty | KANSAS CITY + FAMILY PRACTICE |
Please comment or provide details below to improve the information on Marvin L Mcintosh.
Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.