Provider Demographics
NPI:1538269816
Name:MCINTOSH, TAMARA ANN (MD)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:ANN
Last Name:MCINTOSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 AL HWY 144
Mailing Address - Street 2:
Mailing Address - City:OHATCHEE
Mailing Address - State:AL
Mailing Address - Zip Code:36271-7887
Mailing Address - Country:US
Mailing Address - Phone:256-892-1241
Mailing Address - Fax:256-892-3733
Practice Address - Street 1:1410 AL HIGHWAY 144
Practice Address - Street 2:
Practice Address - City:OHATCHEE
Practice Address - State:AL
Practice Address - Zip Code:36271-7887
Practice Address - Country:US
Practice Address - Phone:256-892-1241
Practice Address - Fax:256-892-3733
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20130207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
51538228OtherBLUE CROSS
AL009939087Medicaid
AL009939087Medicaid
51538228OtherBLUE CROSS