Provider Demographics
NPI:1285863001
Name:MCINTOSH, LEDTKEY RONNIE JR (RD)
Entity Type:Individual
Prefix:
First Name:LEDTKEY
Middle Name:RONNIE
Last Name:MCINTOSH
Suffix:JR
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15702 EAST HIGHWAY 9
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73026
Mailing Address - Country:US
Mailing Address - Phone:405-360-0698
Mailing Address - Fax:405-573-6734
Practice Address - Street 1:15702 EAST HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73026-9001
Practice Address - Country:US
Practice Address - Phone:405-360-0698
Practice Address - Fax:405-573-6734
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered