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Organization
SAINT ALPHONSUS PHYSICIAN SERVICES INC
Active
Organization
SAINT ALPHONSUS PHYSICIAN SERVICES INC
Active
Other names
Saint Alphonsus Medical Group Eagle Health Plaza
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANELLE G. REILLY (PRESIDENT)
(208) 367-6490
Entity
Organization
Contact information
Practice address
323 EAST RIVERSIDE DRIVE, SUITE 224, EAGLE, ID 83616-6865
(208) 367-5750
(208) 367-5765
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
—
NULL
367A00000X
Advanced Practice Midwife
—
—
Other
Enumeration date
05/18/2006
Last updated
12/21/2007
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