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

University of Utah Pediatric Services

Organization Pediatrics Physician · NPI 1669918769

University of Utah Pediatric Services is a Pediatrics Physician in Idaho Falls, Idaho. Registered with an NPI since 2017.

In the registry since
2017
Specialties on file
2

Practice location Address checks out

1645 Pancheri Dr
Idaho Falls, ID 83402-3169
Phone: (208) 227-1460
Show map & directions

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
Pediatrics Physician Taxonomy 208000000X

Record details

NPI number1669918769
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationUniversity of Utah Pediatric Services
Authorized official Edward Clark — Department Chair · (801) 587-6336
Other names Pediatric Neurology - Idaho Falls; Pediatric Neurology - Idaho Falls
NPI enumeratedJanuary 12, 2017
Last updated in NPPESMay 21, 2020
Certification dateMay 21, 2020
Mailing addressPo Box 841450, Los Angeles, CA 90084-1450

Other providers in Idaho Falls