Provider Demographics
NPI:1811903412
Name:KINTZ, J JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:J
Middle Name:JOSEPH
Last Name:KINTZ
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 1:3355 RIVERBEND DR
Mailing Address - Street 2:SUITE 240
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-8800
Mailing Address - Country:US
Mailing Address - Phone:541-687-8304
Mailing Address - Fax:541-349-1483
Practice Address - Street 1:3355 RIVERBEND DR
Practice Address - Street 2:SUITE 240
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-8800
Practice Address - Country:US
Practice Address - Phone:541-687-1712
Practice Address - Fax:541-687-7943
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD11466207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORD86864Medicare UPIN
OR108339Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER