Provider Demographics
NPI:1053367714
Name:MCALISTER, MITCHELL SCOTT (MD)
Entity type:Individual
Prefix:
First Name:MITCHELL
Middle Name:SCOTT
Last Name:MCALISTER
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 1:2595 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104
Mailing Address - Country:US
Mailing Address - Phone:901-260-8551
Mailing Address - Fax:901-260-8590
Practice Address - Street 1:2400 POPLAR AVE
Practice Address - Street 2:SUITE 501
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-3213
Practice Address - Country:US
Practice Address - Phone:901-271-0896
Practice Address - Fax:901-271-0897
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR3759207V00000X
TN15049207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1523532Medicaid
TN1523532Medicaid
TN103I160443Medicare PIN