Individual
DR. ALAN WALLACE MCINNES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
323 E RIVERSIDE DR, SUITE 136, EAGLE, EAGLE, ID 83616-6865
(208) 939-2939
Mailing address
323 E RIVERSIDE DR, SUITE 136, EAGLE, ID 83616-6865
(208) 939-2939
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
5755878-1205
UT
207W00000X
Ophthalmology Physician
A98662
CA
207W00000X
Ophthalmology Physician
Primary
M11139
ID
Other
Enumeration date
02/21/2007
Last updated
10/30/2012
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