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
Phone: (208) 552-1406
Fax: (208) 552-1416
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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