NPI 1154549616

Teton Plastic Surgery

Organisation Plastic and Reconstructive Surgery Physician Idaho Falls, ID

Practice location

Address: 2860 Channing Way Suite 213, Idaho Falls, ID 83404-7531
Phone: (208) 552-1406
Fax: (208) 552-1416
Mailing address: PO Box 1769, Idaho Falls, ID 83403-1769

Authorised official

Name: Jennifer Martin
Title: Office Manager
Phone: (208) 552-1406

Registered specialties

Plastic and Reconstructive Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2086S0122X Licence M-8270 (ID)

Other Surgery providers in Idaho →

Registry record

NPI: 1154549616
Entity type: Organization
NPI issued: 23 Apr 2007
Record last updated: 7 Mar 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.