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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | McIntosh, Cooper A. | [sources] | |||
| Birth date | [sources] | ||||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| NPI | 1780791004 | [sources] | |||
| Sector | Physician | [sources] | |||
| Address | 551 Azalea Drive Oxford, MS 38655 | [sources] | |||
| Last change | Last processed | First seen | |||
Service providers who have been terminated for cause from Mississippi's Medicaid program.
United States of America · Mississippi Division of Medicaid
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