Physician Compare National (NPI:1942345228)

HEALTHCARE PROVIDER: ALAN WALLACE MCINNES JR. M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1942345228
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8628159332
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120118000381
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MCINNES
	Individual professional last name
Provider First Name	ALAN
	Individual professional first name
Provider Middle Name	W
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF UTAH SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2000
	Individual professional's medical school graduation year
Primary Specialty	OPHTHALMOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PLASTIC AND RECONSTRUCTIVE SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PLASTIC AND RECONSTRUCTIVE SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	3357 W BAVARIA ST
	Group Practice or individual's line 1 address
City	EAGLE
	Group Practice or individual's city
State	ID
	Group Practice or individual's state
Zip Code	836165341
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	130006
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST LUKE'S REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	130007
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SAINT ALPHONSUS REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	130013
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SAINT ALPHONSUS MEDICAL CENTER - NAMPA
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	130071
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	ST LUKE'S NAMPA MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y