| Doctor Name: | DR. KYLE MCINTOSH |
| NPI Number: | 1609216050 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 1225 |
| Business Practice Address: | 4700 Las Vegas Blvd N Nellis Afb, NV - 891916600 |
| Business Phone Number: | 7026533040 |
| Business Fax Number: | 7026532115 |
| Mailing Address: | 4700 Las Vegas Blvd N, NELLIS AFB |
| State: | NV |
| Postal Code: | 891916600 |
| Phone Number: | 7026533040 |
| Fax Number: | 7026532115 |
| NPI Enumeration Date: | 06/30/2013 |
| NPI Last Update Date: | 02/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 1225 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |