| Eastern Idaho Neurological Associates Pa | |
|
2353 Coronado Drive Idaho Falls ID 83404 | |
| (208) 552-4823 | |
| (208) 552-4856 |
| Full Name | Eastern Idaho Neurological Associates Pa |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 2353 Coronado Drive, Idaho Falls, Idaho |
| Authorized Official Name and Position | Stephen G Vincent (OWNER) |
| Authorized Official Contact | 2085524823 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Idaho Neurological Associates Pa 2353 Coronado Drive Idaho Falls ID 83404 Ph: (208) 552-4823 | Eastern Idaho Neurological Associates Pa 2353 Coronado Drive Idaho Falls ID 83404 Ph: (208) 552-4823 |
| NPI Number | 1437252723 |
|---|---|
| Provider Enumeration Date | 09/05/2006 |
| Last Update Date | 01/06/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437252723 | NPI | - | NPPES |
| 002724000 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | M6269 (Idaho) | Primary |
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