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

Grand Teton Child Neurology

Organization Neurology with Special Qualifications in Child Neurology Physician · NPI 1639322258

Grand Teton Child Neurology is a Neurology with Special Qualifications in Child Neurology Physician in Idaho Falls, Idaho. Registered with an NPI since 2008.

In the registry since
2008
Specialties on file
2

Practice location Address checks out

2225 Teton Plz Ste B
Idaho Falls, ID 83404-6494
Phone: (208) 529-4300
Fax: (208) 529-1627
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurology with Special Qualifications in Child Neurology Physician (primary) Taxonomy 2084N0402X
Community/Behavioral Health Agency Taxonomy 251S00000X

Record details

NPI number1639322258
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Peter Castellanos — Neurologist · (208) 529-4300
NPI enumeratedOctober 28, 2008
Last updated in NPPESAugust 17, 2021
Certification dateAugust 17, 2021
Mailing address2225 Teton Plz Ste B, Idaho Falls, ID 83404-6494

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