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NPI Code Detail

MEDICARE: MS. JONI MCINTYRE PA-C

MEDICARE: MS. JONI MCINTYRE PA-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
1363A00000XPhysician Assistant3755AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881875128
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JONI MCINTYRE PA-C
Provider Business Mailing Address
First Line : 2320 N 3RD ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-1303
Country : US
Telephone Number : 602-258-9900
Fax Number : 602-258-9904
Provider Business Practice Location Address
First Line : 2320 N 3RD ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-1303
Country : US
Telephone Number : 602-340-0201
Fax Number : 602-340-0367
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2007
Last Update Date : 08/05/2015

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