Provider Demographics
NPI:1427080654
Name:MCINTYRE, RICHARD DEAN (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DEAN
Last Name:MCINTYRE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:R
Other - Middle Name:DEAN
Other - Last Name:MCINTYRE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:818 E CLARK BLVD
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-2324
Mailing Address - Country:US
Mailing Address - Phone:615-895-2800
Mailing Address - Fax:615-895-2860
Practice Address - Street 1:818 E CLARK BLVD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-2324
Practice Address - Country:US
Practice Address - Phone:615-895-2800
Practice Address - Fax:615-895-2860
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2018111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3729540Medicare ID - Type UnspecifiedGROUP
TNU79851Medicare UPIN
TN3973484Medicare ID - Type UnspecifiedINDIVIDUAL