Teton Retinal Institute Pa

LBN: Teton Retinal Institute Pa
Teton Retinal Institute Pa is an health care organization with primary practice located at 3544 E 17Th St Ste 105, Ammon ID 83406-6911. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as the primary health care specialty. Teton Retinal Institute Pa can be contacted via phone (208) 535-4900, or through Moffett, Darryl G via phone (208) 535-4900.

Contact Information

Primary practice address
3544 E 17Th St Ste 105 Ammon ID 83406-6911
Phone: (208) 535-4900
Fax: (208) 535-4906
Website:
Map and Directions
Authorized official contact:
Name: Moffett, Darryl G Doctor of Medicine (MD)
Phone: (208) 535-4900

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X M6263 Idaho

Profile Details

NPI number 1437274057
LBN Legal business name Teton Retinal Institute Pa
DBA Doing business as
Authorized official Moffett, Darryl G Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 20th, 2007
Last updated Nov 18th, 2015 - about 11 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 1437274057 NPPES
Idaho Other 8G320 BLUE CROSS GROUP

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