Provider Demographics
NPI:1932200656
Name:MCINTYRE, FREDERICK LINDSEY JR (PA-C)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:LINDSEY
Last Name:MCINTYRE
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 CHARLOTTE HWY
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-9673
Mailing Address - Country:US
Mailing Address - Phone:828-296-0880
Mailing Address - Fax:828-296-0855
Practice Address - Street 1:136 CHARLOTTE HWY
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-9673
Practice Address - Country:US
Practice Address - Phone:828-296-0880
Practice Address - Fax:828-296-0855
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC100306363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCS54899Medicare UPIN
NC2753942Medicare PIN