Provider Demographics
NPI:1205827920
Name:MCINTOSH, WILLIAM D (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:D
Last Name:MCINTOSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2292 DALTON DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043
Mailing Address - Country:US
Mailing Address - Phone:931-645-5595
Mailing Address - Fax:931-645-5596
Practice Address - Street 1:2292 DALTON DR
Practice Address - Street 2:SUITE C
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043
Practice Address - Country:US
Practice Address - Phone:931-645-5595
Practice Address - Fax:931-645-5596
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2011-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN24236207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3098619Medicaid
TN160029769OtherRR MEDICARE
F58692Medicare UPIN
TN3098619Medicaid