MEDICARE: DR. RICHARD MATTHEW MCINTYRE D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NX0800X	Orthopedic Chiropractor	B 149	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	668342	OTHER	NV	ANTHEM BCBS HMO, PPO

General Provider Information

NPI Number	:	1760482756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD MATTHEW MCINTYRE D.C.

Provider Business Mailing Address
First Line	:	3046 HARTSVILLE RD
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-8514
Country	:	US
Telephone Number	:	702-914-6950
Fax Number	:	702-914-6950

Provider Business Practice Location Address
First Line	:	9555 S EASTERN AVE
Second Line	:	SUITE 240
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-8008
Country	:	US
Telephone Number	:	702-301-3862
Fax Number	:	702-914-6950

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. RICHARD MATTHEW MCINTYRE D.C.” Practice Location

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