Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Eagle Rock Regional Neurology, PC

Organization Neurology Physician · NPI 1710053756

Eagle Rock Regional Neurology, PC is a Neurology Physician in Idaho Falls, Idaho. Licensed in Idaho. Registered with an NPI since 2006.

Licensed in
ID
In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1995 E 17th St Ste 5
Idaho Falls, ID 83404-6493
Phone: (208) 552-5700
Fax: (208) 552-5703
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X · Licence O343 (ID)

Record details

NPI number1710053756
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official William Domarad — Physician · (208) 552-5700
NPI enumeratedNovember 28, 2006
Last updated in NPPESAugust 22, 2020
Mailing address1995 E 17th St, Ste 5, Idaho Falls, ID 83404-6493

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