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UNIVERSITY OF UTAH PEDIATRIC SERVICES NPI 1669918769


NPI Information

NPI: 1669918769
Provider Name: UNIVERSITY OF UTAH PEDIATRIC SERVICES

Doing Business As: PEDIATRIC NEUROLOGY - IDAHO FALLS

Classification: Psychiatry & Neurology - 2084N0402X
Entity Type: Organization

Specialization: Neurology with Special Qualifications in Child Neurology

Address:
1645 PANCHERI DR
IDAHO FALLS, ID
ZIP 83402
Phone: (208) 227-1460
Get Directions

UNIVERSITY OF UTAH PEDIATRIC SERVICES is a neurology with special qualifications in child neurology psychiatry neurology in Idaho Falls, ID. The provider is a Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. UNIVERSITY OF UTAH PEDIATRIC SERVICES NPI is 1669918769. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Pediatric Neurology - Idaho Falls.

The provider's business location address is:

1645 PANCHERI DR
IDAHO FALLS, ID
ZIP 83402-169
Phone: (208) 227-1460

The provider's authorized official is Edward Clark .
The authorized official title is Department Chair and has the following contact phone number (801) 587-6336.

The enumeration date for this NPI number is 1/12/2017 and was last updated on 5/21/2020.


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
1208000000XPediatricsNo
22084N0402XPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyYes

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: 4/28/2024

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