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EAST FALLS PLASTIC SURGERY LLC NPI 1023267895


NPI Information

NPI: 1023267895
Provider Name: EAST FALLS PLASTIC SURGERY LLC
Classification: Plastic Surgery - 208200000X
Entity Type: Organization
Address:
2860 CHANNING WAY
SUITE 114A
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 535-4565
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EAST FALLS PLASTIC SURGERY LLC is a plastic surgery in Idaho Falls, ID. The provider is a plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. EAST FALLS PLASTIC SURGERY LLC NPI is 1023267895. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2860 CHANNING WAY
SUITE 114A
IDAHO FALLS, ID
ZIP 83404-531
Phone: (208) 535-4565
Fax: (208) 535-4564

The provider's authorized official is David J. Kane .
The authorized official title is Vp and has the following contact phone number (801) 568-5933.

The enumeration date for this NPI number is 9/16/2008 and was last updated on 2/18/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208200000XPlastic SurgeryIDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1808218000MEDICAIDIDAHO
21023267895MEDICAIDIDAHO
31023267895MEDICAIDWYOMING
41370117MEDICARE PINIDAHO
51023267895MEDICAIDMONTANA
6DO4902MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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