MEDICARE: NEIL W MCALLISTER OD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	1407	CO

General Provider Information

NPI Number	:	1083731020
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEIL W MCALLISTER OD PC

Provider Business Mailing Address
First Line	:	6160 TUTT BLVD
Second Line	:	SUITE 220
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-3500
Country	:	US
Telephone Number	:	719-598-5068
Fax Number	:	719-598-5068

Provider Business Practice Location Address
First Line	:	6160 TUTT BLVD
Second Line	:	SUITE 220
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-3500
Country	:	US
Telephone Number	:	719-598-5068
Fax Number	:	719-694-2266

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	NEIL WILFORD MCALLISTER
Credential	:	OD
Telephone Number	:	719-598-5068

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	04/30/2021

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