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Contact Information

TETON RADIOLOGY DIAGNOSTIC A SERIES OF TETON GROUP ENTERPRISE
2001 S WOODRUFF AVE STE 17
IDAHO FALLS, ID83404-6372
 Phone: 208-524-7237
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Body Imaging

2085B0100X
 

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
 

Diagnostic Ultrasound

2085U0001X
 

Neuroradiology

2085N0700X
 

Nuclear Radiology

2085N0904X
 

Pediatric Radiology

2085P0229X
 

Radiation Oncology

2085R0001X 92 Physician/Radiation Oncology
 

Radiation Oncology

2085R0203X
 

Radiological Physics

2085R0205X
 

Vascular & Interventional Radiology

2085R0204X 94 Physician/Interventional Radiology
Indicates primary specialty

NPI Profile & details for TETON RADIOLOGY DIAGNOSTIC A SERIES OF TETON GROUP ENTERPRISE

NPI Number 1013085604
LBN Legal business name TETON RADIOLOGY DIAGNOSTIC A SERIES OF TETON GROUP ENTERPRISE
Authorized official MICHAEL HODEL - (GENERAL MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/01/2006
Last updated 01/05/2026 - About 5 months ago
Identifiers
ID Medicaid 807617900
Other DF6608 RAILROAD MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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