Grand Teton Child Neurology is a Child Neurology Clinic in Idaho Falls, Idaho. It is located at 2225 Teton Plz Ste B, Idaho Falls, ID and its contact number is 208-529-4300. The authorized person for Grand Teton Child Neurology is Dr. Peter W Castellanos
who is Neurologist of the clinic and his/her contact number is 208-529-4300. Grand Teton Child Neurology Clinic specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.
Complete Clinic Profile:
Grand Teton Child Neurology Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Grand Teton Child Neurology
Specialization:
Child Neurology
Clinic Address:
2225 Teton Plz Ste B, Idaho Falls, Idaho, 83404-6494
Phone:
208-529-4300
Fax:
208-529-1627
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Dr. Peter W Castellanos
Position:
Neurologist
Contact Number:
208-529-4300
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Grand Teton Child Neurology clinic are as mentioned below.
NPI Number:
1639322258
NPI Enumeration Date:
28 Oct, 2008
NPI Last Update On:
17 Aug, 2021
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Grand Teton Child Neurology are as mentioned below.
Specialization
License Number
State
Status
Neurology with Special Qualifications in Child Neurology
Primary
Community/behavioral Health
Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
77234
Other
Idaho
Blue Cross Of Idaho
807968700
Medicaid
Idaho
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Grand Teton Child Neurology 2225 Teton Plz Ste B, Idaho Falls, Idaho
Zip:
83404-6494
Phone Number:
208-529-4300
Fax Number:
208-881-5121
Patients can reach Grand Teton Child Neurology at 2225 Teton Plz Ste B, Idaho Falls, Idaho or can call to book an appointment on 208-529-4300. *Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 December, 2024.