Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 8269477-1205 | UT |
Y | 207QS0010X | Family Doctor - Sports Medicine | 8269477-1205 | UT |
NPI | 1043446602 |
---|---|
Provider Name | James Steele Mcintyre |
First Address | West Jordan, UT 84084-4312 |
Second Address | West Valley City, UT 84120 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2009 |
Last Update Date | 02/07/2019 |