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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. ALAN WALLACE MCINNES JR., M.D.

Active

Ophthalmology · EAGLE, ID

Registration Details

NPI Number
1942345228
Provider Type
Individual
Gender
Male
NPI Issued
Feb 21, 2007 (19.180359673645 yrs)
Last Updated
Oct 30, 2012
Licenses
A98662 (CA)
5755878-1205 (UT)
M11139 (ID)

Practice Information

Address
323 E RIVERSIDE DR, SUITE 136
EAGLE
EAGLE, ID, 836166865
Browse ID providers · Browse ZIP 83616
Phone
2089392939
Primary Specialty
Ophthalmology
207W00000X
Additional Specialty
Ophthalmology
Additional Specialty
Ophthalmology
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.