Provider Demographics
NPI:1134193626
Name:MCINTYRE, WILLIAM J (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:MCINTYRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:276 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24263-1215
Mailing Address - Country:US
Mailing Address - Phone:276-546-5310
Mailing Address - Fax:276-546-5469
Practice Address - Street 1:162 MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:HAYSI
Practice Address - State:VA
Practice Address - Zip Code:24256-0653
Practice Address - Country:US
Practice Address - Phone:276-865-5121
Practice Address - Fax:276-546-9707
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2022-09-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY23810207P00000X
CAG54048207P00000X
VA0101044775207P00000X, 207PE0004X
WV12849207P00000X
PAMD026082E207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services