MEDICARE: DR. NEIL WILFORD MCALLISTER OD

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	:	1932209897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEIL WILFORD MCALLISTER OD

Provider Business Mailing Address
First Line	:	6160 TUTT BLVD 220
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-3502
Country	:	US
Telephone Number	:	719-598-5068
Fax Number	:	719-598-5068

Provider Business Practice Location Address
First Line	:	6160 TUTT BLVD 220
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-3502
Country	:	US
Telephone Number	:	719-598-5068
Fax Number	:	719-598-5068

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

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	04/30/2021

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