| Doctor Name: | MARY ELLEN MCINTIRE |
| NPI Number: | 1982634028 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 36832 |
| Business Practice Address: | 111 W Cedar Ln Ste A Payson, AZ - 855415417 |
| Business Phone Number: | 9284724675 |
| Business Fax Number: | 9284723431 |
| Mailing Address: | 111 W Cedar Ln Ste A, PAYSON |
| State: | AZ |
| Postal Code: | 855415417 |
| Phone Number: | 9284724675 |
| Fax Number: | 9284723431 |
| NPI Enumeration Date: | 07/04/2006 |
| NPI Last Update Date: | 10/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 36832 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |