Healthcare Provider Details

I. General information

NPI: 1568698074
Provider Name (Legal Business Name): JEFFREY EUGENE MCALISTER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2009
Last Update Date: 07/28/2021
Certification Date: 07/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 E 2ND ST STE 206
SCOTTSDALE AZ
85251-5610
US

IV. Provider business mailing address

7301 E 2ND ST STE 206
SCOTTSDALE AZ
85251-5610
US

V. Phone/Fax

Practice location:
  • Phone: 602-761-7819
  • Fax: 602-324-7199
Mailing address:
  • Phone: 602-761-7819
  • Fax: 866-939-2673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number0764
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number0764
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0116021668
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36.003606
License Number StateOH
# 5
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0764
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: