Organization
ST ALPHONSUS PROFESSIONAL MEDICAL SERVICES LLC
Active
Other names
SAMG Anesthesia
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN CHECKETTS (CHIEF FINANCIAL OFFICER)
(208) 367-7347
Entity
Organization
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-6416
(208) 367-2742
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002786200
—
ID
Enumeration date
07/09/2006
Last updated
06/16/2025
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