Provider Demographics
NPI:1427316942
Name:PERRY, ALVIN PAUL III (MD)
Entity type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:PAUL
Last Name:PERRY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8854 W EMERALD ST STE 140
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-4845
Mailing Address - Country:US
Mailing Address - Phone:208-302-2600
Mailing Address - Fax:
Practice Address - Street 1:8854 W EMERALD ST STE 140
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-4845
Practice Address - Country:US
Practice Address - Phone:208-321-4790
Practice Address - Fax:208-321-4836
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.152323208600000X, 2086S0102X, 2086S0127X
IDM-14120208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery