Provider Demographics
NPI:1437148897
Name:MCALLISTER, JEANANN R (MD)
Entity Type:Individual
Prefix:
First Name:JEANANN
Middle Name:R
Last Name:MCALLISTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 LEONARD AVE STE 300
Mailing Address - Street 2:WASHINGTON PHYSICIANS GROUP
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-3368
Mailing Address - Country:US
Mailing Address - Phone:724-579-1075
Mailing Address - Fax:
Practice Address - Street 1:95 LEONARD AVE STE 300
Practice Address - Street 2:WASHINGTON PHYSICIANS GROUPO
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-3368
Practice Address - Country:US
Practice Address - Phone:724-579-1075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD066655L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0897132Medicaid
PA1389798OtherHIGHMARK
H29907Medicare UPIN
PA0897132Medicaid