Basic Information
| Provider Information | |||||||||
| NPI: | 1134193626 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCINTYRE | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 276 FIELDSTONE DR | ||||||||
| Address2: | |||||||||
| City: | JONESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 242631215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2765465310 | ||||||||
| FaxNumber: | 2765465469 | ||||||||
| Practice Location | |||||||||
| Address1: | 162 MEDICAL CENTER BLVD | ||||||||
| Address2: | |||||||||
| City: | HAYSI | ||||||||
| State: | VA | ||||||||
| PostalCode: | 242560653 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2768655121 | ||||||||
| FaxNumber: | 2765469707 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2006 | ||||||||
| LastUpdateDate: | 09/13/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 23810 | KY | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | G54048 | CA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 0101044775 | VA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 12849 | WV | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | MD026082E | PA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207PE0004X | 0101044775 | VA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services |
No ID Information.