NPI age
14 years
Enumerated 2011-06-17
● Active Type 2 · Organization
Aesthetic Eye Pc
Aesthetic Eye Pc is 1 of 305 specialist organizations in Idaho.
Primary specialty
Specialist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
McInnes
President
Last NPPES update
2011-06-17
Source: monthly bulk 2026-05
How this organization compares
Across 305 active specialist providers in Idaho.
NPI age
14 years
↓ 4 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2011 → 2026
2011-06Enumerated in NPPES
2011
2026
Where they practice
Primary practice location
360 E 9th St #3
Ketchum, ID 83340
Mailing address
2640 Creekside Dr
Lodi, CA 952428341
Authorized official
Alan W McInnes, MD
President
📞 2099812747
Specialties
-
Specialist PrimaryAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 1942345228 | INDIVIDUAL NPI |
| 01 (ID) | M-11139 | MD LICENSE |
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.