Organization · Type 2 NPI
Teton Radiology Madison LLC
Body Imaging Physician · Rexburg, ID
NPI number
1407081060
Active
Practice location
425 E 4th N
Rexburg, ID 83440-5390
Mailing address
PO Box 30015, Dept 595
Salt Lake City, UT 84130-0015
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Body Imaging Physician Primary | 2085B0100X | None listed |
Body Imaging Physician: A Radiology doctor of Osteopathy that specializes in Body Imaging.
About NPI 1407081060
Teton Radiology Madison LLC's National Provider Identifier is 1407081060, issued on May 26, 2009. The primary taxonomy on file is Body Imaging Physician (2085B0100X), and the practice location is in Rexburg, ID. The record was last updated on Oct 19, 2026.