Provider Demographics
NPI:1619981024
Name:MCALISTER, JOSEPH H JR
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:H
Last Name:MCALISTER
Suffix:JR
Gender:M
Credentials:
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 857
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72740-0857
Mailing Address - Country:US
Mailing Address - Phone:479-738-2040
Mailing Address - Fax:
Practice Address - Street 1:945 N GASKILL ST
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72740-8966
Practice Address - Country:US
Practice Address - Phone:479-738-2040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2298152W00000X
TX2853152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR103297722Medicaid
17259000040OtherQUAL CHOICE
T20334Medicare UPIN
AR103297722Medicaid
AR0703290001Medicare NSC