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Organization

ST ALPHONSUS PROFESSIONAL MEDICAL SERVICES LLC

Active
Other names
St Alphonsus Trauma Physician Services
Organization subpart
No

Provider details

NPI number
Authorized official
RICHARD PRESNELL (CHIEF FINANCIAL OFFICER)
(208) 367-2881
Entity
Organization

Contact information

Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-7676
Mailing address
PO BOX 9589, BOISE, ID 83707-4589
(208) 367-8111
(208) 344-1926

Taxonomy

Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary

Other

Enumeration date
07/17/2006
Last updated
07/23/2007
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