Pediatric Neurology - Idaho Falls

LBN: University Of Utah Pediatric Services
Pediatric Neurology - Idaho Falls is an health care organization with primary practice located at 1645 Pancheri Dr , Idaho Falls ID 83402-3169. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology. Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology is the primary health care specialty. University Of Utah Pediatric Services can be contacted via phone (208) 227-1460, or through Clark, Edward via phone (801) 587-6336.

Contact Information

Primary practice address
1645 Pancheri Dr Idaho Falls ID 83402-3169
Phone: (208) 227-1460
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Clark, Edward Doctor of Medicine (MD)
Phone: (801) 587-6336

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology 2084N0402X

Profile Details

NPI number 1669918769
LBN Legal business name University Of Utah Pediatric Services
DBA Doing business as Pediatric Neurology - Idaho Falls
Authorized official Clark, Edward Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 12th, 2017
Last updated May 21st, 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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