Provider Demographics
NPI:1124079298
Name:MCINTOSH, EMMAKATHERINE LOGAN (PA)
Entity type:Individual
Prefix:MRS
First Name:EMMAKATHERINE
Middle Name:LOGAN
Last Name:MCINTOSH
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:4425 PAULSEN ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-3662
Mailing Address - Country:US
Mailing Address - Phone:912-355-6615
Mailing Address - Fax:912-525-1325
Practice Address - Street 1:4425 PAULSEN ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-3662
Practice Address - Country:US
Practice Address - Phone:912-355-6615
Practice Address - Fax:912-525-1325
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2020-02-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA3533363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant