Provider Demographics
NPI:1508855149
Name:MCANALLY, HEATH (MD)
Entity Type:Individual
Prefix:DR
First Name:HEATH
Middle Name:
Last Name:MCANALLY
Suffix:
Gender:M
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:PO BOX 771698
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-1698
Mailing Address - Country:US
Mailing Address - Phone:907-622-7246
Mailing Address - Fax:
Practice Address - Street 1:12103 HORSESHOE DR
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7547
Practice Address - Country:US
Practice Address - Phone:907-622-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41945207L00000X
AK5890207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology