Provider Demographics
NPI:1144634064
Name:MCALISTER VISION CLINIC
Entity type:Organization
Organization Name:MCALISTER VISION CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MCALISTER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:479-738-2040
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:479-738-6410
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:479-738-6410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2298152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR103297722Medicaid