Provider Demographics
NPI:1710995170
Name:SAINT ALPHONSUS PHYSICIANS, PA
Entity Type:Organization
Organization Name:SAINT ALPHONSUS PHYSICIANS, PA
Other - Org Name:ST. ALPHONSUS PAIN MANAGEMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:208-367-6277
Mailing Address - Street 1:901 N CURTIS RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-1338
Mailing Address - Country:US
Mailing Address - Phone:208-367-4343
Mailing Address - Fax:208-367-7667
Practice Address - Street 1:901 N CURTIS RD
Practice Address - Street 2:SUITE 304
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-1338
Practice Address - Country:US
Practice Address - Phone:208-367-4343
Practice Address - Fax:208-367-7667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty