Eagle Rock Regional Neurology, P.C.

LBN: Eagle Rock Regional Neurology, P.C.
Eagle Rock Regional Neurology, P.C. is an health care organization with primary practice located at 1995 E 17Th St Ste 5, Idaho Falls ID 83404-6493. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as the primary health care specialty. Eagle Rock Regional Neurology, P.C. can be contacted via phone (208) 552-5700, or through Domarad, William Karl via phone (208) 552-5700.

Contact Information

Primary practice address
1995 E 17Th St Ste 5 Idaho Falls ID 83404-6493
Phone: (208) 552-5700
Fax: (208) 552-5703
Website:
Map and Directions
Authorized official contact:
Name: Domarad, William Karl Doctor of Osteopathy (DO)
Phone: (208) 552-5700

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X O343 Idaho

Profile Details

NPI number 1710053756
LBN Legal business name Eagle Rock Regional Neurology, P.C.
DBA Doing business as
Authorized official Domarad, William Karl Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 28th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710053756 NPPES
Idaho Other S5247 BLUE CROSS

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