Provider Demographics
NPI:1497857965
Name:MCALLISTER, JOHN W (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:W
Last Name:MCALLISTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 430
Mailing Address - Street 2:
Mailing Address - City:ST. PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-0008
Mailing Address - Country:US
Mailing Address - Phone:636-441-3444
Mailing Address - Fax:636-441-9832
Practice Address - Street 1:112 PIPER HILL DRIVE
Practice Address - Street 2:SUITE 9
Practice Address - City:ST. PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1690
Practice Address - Country:US
Practice Address - Phone:636-441-3444
Practice Address - Fax:636-441-9832
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR3J06207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOE55028Medicare UPIN
MO000002393Medicare ID - Type UnspecifiedMEDICARE ID