Provider Demographics
NPI:1063674505
Name:WALSH, JOSEPH ALOYSIUS III (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ALOYSIUS
Last Name:WALSH
Suffix:III
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3340 E GOLDSTONE DR.
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642
Mailing Address - Country:US
Mailing Address - Phone:208-302-0000
Mailing Address - Fax:208-302-0055
Practice Address - Street 1:6140 W CURTISIAN AVE STE 100
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704
Practice Address - Country:US
Practice Address - Phone:208-302-0000
Practice Address - Fax:208-302-0055
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2023-01-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA123966207RI0011X
IDM-15215207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology