Provider Demographics
NPI:1952470239
Name:MCALLISTER, YVONNE P (MD)
Entity Type:Individual
Prefix:DR
First Name:YVONNE
Middle Name:P
Last Name:MCALLISTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BETTY
Other - Middle Name:YVONNE
Other - Last Name:POWERS MCALLISTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2410 INGLESIDE AVE
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-2036
Mailing Address - Country:US
Mailing Address - Phone:478-845-7462
Mailing Address - Fax:855-791-3372
Practice Address - Street 1:2410 INGLESIDE AVE
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-2036
Practice Address - Country:US
Practice Address - Phone:478-845-7462
Practice Address - Fax:855-791-3372
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA025218207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00302277BMedicaid
D30167Medicare UPIN
GA08BDPFQMedicare ID - Type Unspecified