Provider Demographics
NPI:1720170053
Name:MCALLISTER, MICHAEL SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SCOTT
Last Name:MCALLISTER
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 1:287 HEALTHWEST DR
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-2031
Mailing Address - Country:US
Mailing Address - Phone:334-792-9500
Mailing Address - Fax:334-793-1815
Practice Address - Street 1:287 HEALTHWEST DR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-2031
Practice Address - Country:US
Practice Address - Phone:334-792-9500
Practice Address - Fax:334-793-1815
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL24229207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051521458OtherBLUE CROSS BLUE SHILED
GA463158903AMedicaid
GA463158903BMedicaid
AL051521458Medicaid
AL051521457OtherBLUE CROSS BLUE SHIELD
AL0342610001Medicare NSC
AL0342610004Medicare NSC
AL051521458OtherBLUE CROSS BLUE SHILED
ALH88891Medicare UPIN