Provider Demographics
NPI:1043835150
Name:MCINTYRE, MACAYLA ELIZABETH
Entity Type:Individual
Prefix:
First Name:MACAYLA
Middle Name:ELIZABETH
Last Name:MCINTYRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CUSHING
Mailing Address - State:OK
Mailing Address - Zip Code:74023-4520
Mailing Address - Country:US
Mailing Address - Phone:918-306-0965
Mailing Address - Fax:
Practice Address - Street 1:1028 E 6TH ST
Practice Address - Street 2:
Practice Address - City:CUSHING
Practice Address - State:OK
Practice Address - Zip Code:74023-4520
Practice Address - Country:US
Practice Address - Phone:918-306-0965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist