Teton Plastic Surgery

LBN: Teton Plastic Surgery
Teton Plastic Surgery is an health care organization with primary practice located at 2860 Channing Way Suite 213, Idaho Falls ID 83404-7531. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as the primary health care specialty. Teton Plastic Surgery can be contacted via phone (208) 552-1406, or through Martin, Jennifer via phone (208) 552-1406.

Contact Information

Primary practice address
2860 Channing Way Suite 213 Idaho Falls ID 83404-7531
Fax: (208) 552-1416
Website:
Authorized official contact:
Name: Martin, Jennifer

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X M-8270 Idaho

Profile Details

NPI number 1154549616
LBN Legal business name Teton Plastic Surgery
DBA Doing business as
Authorized official Martin, Jennifer
Entity Organization
Organization subpart 1 No
Enumeration date Apr 23rd, 2007
Last updated Mar 7th, 2023 - about 3 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 1154549616 NPPES
Idaho Other M-8270 ID MEDICAL LICENSE
Idaho Other 5959620-1205 ID MEDICAL LICENSE
Idaho Other 5959620-8905 ID MEDICAL LICENSE
Idaho Other 6687A ID MEDICAL LICENSE
Idaho Other CS9201 ID MEDICAL LICENSE
Idaho Other 58MKM02 ID MEDICAL LICENSE
Idaho Other 04232007480947 ID MEDICAL LICENSE

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