Organization · Type 2 NPI

Teton Plastic Surgery

Plastic and Reconstructive Surgery Physician · Idaho Falls, ID

NPI number 1154549616 Active

Practice location

2860 Channing Way, Suite 213
Idaho Falls, ID 83404-7531

Call (208) 552-1406 Map

Fax (208) 552-1416

Mailing address

PO Box 1769
Idaho Falls, ID 83403-1769

Specialties and licenses

TaxonomyCodeLicense
Plastic and Reconstructive Surgery Physician Primary 2086S0122XM-8270 (ID)

Plastic and Reconstructive Surgery Physician: A surgeon who specializes in plastic and reconstructive surgery.

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About NPI 1154549616

Teton Plastic Surgery's National Provider Identifier is 1154549616, issued on Apr 23, 2007. The primary taxonomy on file is Plastic and Reconstructive Surgery Physician (2086S0122X), and the practice location is in Idaho Falls, ID. The record was last updated on Mar 7, 2023.