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General NPI Number Information
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NPI Number | 1235651563
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Entity Type | Individual
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Provider Name | JOSHUA MCINTOSH APRN
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Gender | Male
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Dates
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Enumeration Date | 07/07/2017
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Last Update Date | 07/11/2017
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Provider Practice Location Address
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Address Line | 501 VIRGINIA DR STE C
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City | BATESVILLE
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State | AR
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Zip | 72501-7317
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Country | US
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Telephone | 870-793-2371
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Fax |
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Provider Business Mailing Address
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Address Line | 501 VIRGINIA DRIVE SUITE C
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City | BATESVILLE
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State | AR
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Zip | 72501-7317
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Country | US
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Telephone | 870-793-2371
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | A005212
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License Number State | AR
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