Provider Demographics
NPI:1710050869
Name:MCINTOSH, DAVID G (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:G
Last Name:MCINTOSH
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 1:9714 S MARION AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-3913
Mailing Address - Country:US
Mailing Address - Phone:918-240-4776
Mailing Address - Fax:
Practice Address - Street 1:915 N GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63106-1621
Practice Address - Country:US
Practice Address - Phone:314-894-6654
Practice Address - Fax:314-894-6614
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17745207VG0400X
OK13117207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4604246OtherAETNA
051523563OtherBCBS AL SVC PROVIDED AL
MS07020061OtherUP MS MCAID NUMBER
AL009902615Medicaid
GA304107Medicaid
58257864831902A001OtherTRICARE WPS
984965OtherBCBS GA
GA00806671BMedicaid
AL009900735Medicaid
060019730OtherBCBS AL SVC PROVIDED GA
AL009900735Medicaid
GA00806671BMedicaid
4604246OtherAETNA
160057350Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MS07020061OtherUP MS MCAID NUMBER