Provider Demographics
NPI:1346341682
Name:MCALLISTER, MARK D (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:D
Last Name:MCALLISTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 21568
Mailing Address - Street 2:DEPT 284
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74121-1568
Mailing Address - Country:US
Mailing Address - Phone:800-915-3089
Mailing Address - Fax:
Practice Address - Street 1:645 N ARLINGTON AVE
Practice Address - Street 2:SUITE 250A
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4505
Practice Address - Country:US
Practice Address - Phone:775-329-7707
Practice Address - Fax:775-329-7767
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2014-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV59892085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV201630Medicaid
NVA58332Medicare UPIN
NVV30WCCGD07Medicare PIN
NV201630Medicaid