Provider Demographics
NPI:1538208723
Name:MCALLISTER, ERIC R (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:R
Last Name:MCALLISTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4308 GRANT LINE RD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-2006
Mailing Address - Country:US
Mailing Address - Phone:812-945-3800
Mailing Address - Fax:812-945-8860
Practice Address - Street 1:4308 GRANT LINE RD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-2006
Practice Address - Country:US
Practice Address - Phone:812-945-3800
Practice Address - Fax:812-945-8860
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001995A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
M400030153OtherMEDICARE (PTAN)
IN200433700-1Medicaid
M400030153OtherMEDICARE (PTAN)