Provider Demographics
NPI:1710956602
Name:MCINTOSH, LORI ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:ANN
Last Name:MCINTOSH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:STUART-HUBBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:P.O. BOX 850489
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36685-0489
Mailing Address - Country:US
Mailing Address - Phone:251-342-3949
Mailing Address - Fax:251-631-3361
Practice Address - Street 1:6701 AIRPORT BLVD STE B215
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3706
Practice Address - Country:US
Practice Address - Phone:251-639-0001
Practice Address - Fax:251-639-3194
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA711322084N0400X
KY030912084N0400X
LADO.00001112084N0400X
FLOS103362084N0400X
AL6282084N0400X
ALDO.16322084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003150253AMedicaid
KY7100044110Medicaid
AL188963Medicaid
AL188963Medicaid