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General NPI Number Information
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NPI Number | 1972164200
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Entity Type | Individual
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Provider Name | SHELBY WAGNER MCINTOSH DO
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Gender | Female
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Dates
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Enumeration Date | 06/26/2019
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 123 BAPTIST WAY
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City | PENSACOLA
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State | FL
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Zip | 32503-2254
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Country | US
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Telephone | 850-434-4694
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Fax |
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Provider Business Mailing Address
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Address Line | 6575 S WINDING BROOK DR
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City | FAIRHOPE
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State | AL
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Zip | 36532-6415
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Country | US
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Telephone |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 7052
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License Number State | OK
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