Provider Demographics
NPI:1366464216
Name:MCINTYRE, JULIAN EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:JULIAN
Middle Name:EDWARD
Last Name:MCINTYRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 BROWN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7005
Mailing Address - Country:US
Mailing Address - Phone:334-747-4159
Mailing Address - Fax:
Practice Address - Street 1:2055 E SOUTH BLVD STE 806
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2007
Practice Address - Country:US
Practice Address - Phone:334-747-8920
Practice Address - Fax:334-747-8930
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00015065207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL201920Medicaid
AL2103641OtherCIGNA
AL511-94296OtherBCBS OF AL
AL511-94297OtherBCBS OF AL
ALF10006OtherVIVA HEALTH
ALP01873138OtherRR MEDICARE
AL51516766OtherBCBS
AL630900020Medicaid
AL630903020Medicaid
AL630906020Medicaid
AL51516762OtherBCBS
AL51516770OtherBCBS
AL630901020Medicaid
AL630902020Medicaid
AL630908020Medicaid
AL201117Medicaid
AL102I67971OtherMEDICARE
AL51083037OtherBCBS
AL51516767OtherBCBS
AL51516769OtherBCBS
ALP00040095OtherRAILROAD
AL51516772OtherBCBS
AL630904020Medicaid
AL511-94298OtherBCBS OF AL
AL51516764OtherBCBS
AL630909020Medicaid
AL51516762OtherBCBS
AL201920Medicaid