MEDICARE: DR. ALISA O MCGILL M.D.

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	208000000X	Pediatrics Physician	35.062191	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2287952	OTHER	OH	AETNA
3	262570002	OTHER	OH	CARESOURCE
4	000000216752	OTHER	OH	ANTHEM
5	010587697028	OTHER	OH	HUMANA
6	1220333	OTHER	OH	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1174521744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALISA O MCGILL M.D.

Provider Business Mailing Address
First Line	:	3333 BURNET AVE
Second Line	:	MLC 7009
City	:	CINCINNATI
State	:	OH
Zip	:	45229-3026
Country	:	US
Telephone Number	:	513-636-4225
Fax Number	:	513-636-2511

Provider Business Practice Location Address
First Line	:	3333 BURNET AVE
Second Line	:	MLC 7009
City	:	CINCINNATI
State	:	OH
Zip	:	45229-3026
Country	:	US
Telephone Number	:	513-636-4225
Fax Number	:	513-636-2511

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	03/06/2015

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Directions to “ DR. ALISA O MCGILL M.D.” Practice Location

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