Teton Radiology Diagnostic Llc

LBN: Teton Radiology Diagnostic A Series Of Teton Group Enterprise
Teton Radiology Diagnostic Llc is an health care organization with primary practice located at 2001 S Woodruff Ave Ste 17 , Idaho Falls ID 83404-6372. The organization recently has 10 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Nuclear Radiology, Allopathic & Osteopathic Physicians / Pediatric Radiology, Allopathic & Osteopathic Physicians / Radiation Oncology, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Therapeutic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Radiological Physics, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound. Allopathic & Osteopathic Physicians / Body Imaging is the primary health care specialty. Teton Radiology Diagnostic A Series Of Teton Group Enterprise can be contacted via phone (208) 524-7237, or through Hodel, Michael P via phone (208) 542-5000.

Contact Information

Primary practice address
2001 S Woodruff Ave Ste 17 Idaho Falls ID 83404-6372
Phone: (208) 524-7237
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Hodel, Michael P
Phone: (208) 542-5000

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X
Allopathic & Osteopathic Physicians / Neuroradiology 2085N0700X
Allopathic & Osteopathic Physicians / Nuclear Radiology 2085N0904X
Allopathic & Osteopathic Physicians / Pediatric Radiology 2085P0229X
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X
Allopathic & Osteopathic Physicians / Therapeutic Radiology 2085R0203X
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X
Allopathic & Osteopathic Physicians / Radiological Physics 2085R0205X
Allopathic & Osteopathic Physicians / Diagnostic Ultrasound 2085U0001X

Profile Details

NPI number 1013085604
LBN Legal business name Teton Radiology Diagnostic A Series Of Teton Group Enterprise
DBA Doing business as Teton Radiology Diagnostic Llc
Authorized official Hodel, Michael P
Entity Organization
Organization subpart 1 No
Enumeration date Dec 1st, 2006
Last updated Nov 20th, 2023 - about last year

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 1013085604 NPPES
Idaho MEDICAID 807617900
Idaho Other DF6608

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