Idaho Falls Pediatrics
Pediatric Adolescent Medicine
Idaho Falls Pediatrics is a Idaho Falls, Idaho based Pediatric center with medical specialization in
Pediatric Adolescent Medicine.
It is located at
2375 Coronado St, Idaho Falls, Idaho - 83404-7407. They can be contacted on phone at
208-522-4600 and fax number 208-552-7521.
NPI number (Unique professional ID) for Idaho Falls Pediatrics is
1366560971 which was assigned by NPPES on 26 Mar, 2007 and it was last updated on 22 Aug, 2020.
Idaho Falls Pediatrics license number is
M7271 for Pediatrics Adolescent Medicine (2080A0000X) in Idaho.
Idaho Falls Pediatrics specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Idaho Falls Pediatrics basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
|---|
| Provider Name : | Idaho Falls Pediatrics |
|---|
Business Address:
Idaho Falls Pediatrics address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 2375 Coronado St
Idaho Falls, ID, 83404-7407
United States |
|---|
| Phone Number : | 208-522-4600 |
|---|
| Fax Number : | 208-552-7521 |
|---|
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 are as mentioned below.
| NPI Number : | 1366560971 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 26 Mar, 2007 |
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| Last Updated On : | 22 Aug, 2020 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Ronwade Porter |
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| Authorized Official Credential : | MD |
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| Official Title or Position : | OWNER |
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| Phone Number : | 208-522-4600 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Idaho Falls Pediatrics are as mentioned. Primary taxonomy code for Idaho Falls Pediatrics is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | M7271 | ID |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 2375 Coronado St
Idaho Falls, ID, 83404-7407
United States |
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| Phone Number : | 208-522-4600 |
|---|
| Fax Number : | 208-552-7521 |
|---|
Business Location:
Patients can refer following map for directions to
Idaho Falls Pediatrics practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.