Provider Demographics
NPI:1114955762
Name:MCALLISTER, FRANK JOEL (DO)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:JOEL
Last Name:MCALLISTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:MS
Other - First Name:DIANE
Other - Middle Name:LYNNE
Other - Last Name:MIHALKO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7435 W AZURE DR
Mailing Address - Street 2:SUITE 190
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-4426
Mailing Address - Country:US
Mailing Address - Phone:702-363-3666
Mailing Address - Fax:702-363-0118
Practice Address - Street 1:7435 W AZURE DR
Practice Address - Street 2:SUITE 190
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-4426
Practice Address - Country:US
Practice Address - Phone:702-363-3666
Practice Address - Fax:702-363-0118
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV525207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVNV1221OtherBLUE CROSS BLUE SHIELD
NV110051801OtherRR MEDICARE
NV002019410Medicaid
NVAR415ZOtherMEDICARE PROVIDER NUMBER
NV110051801OtherRR MEDICARE