Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology
UNIVERSITY OF UTAH PEDIATRIC SERVICES
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1669918769 · enumerated 2017-01-12 · record updated 2020-05-21. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: EDWARD CLARK MD, Department Chair · (801) 587-6336
Other names: PEDIATRIC NEUROLOGY - IDAHO FALLS
Addresses and phones
- Practice location 1645 PANCHERI DR, IDAHO FALLS, ID, 83402-3169 (208) 227-1460 Google Maps Apple Maps OpenStreetMap
- Mailing address PO BOX 841450, LOS ANGELES, CA, 90084-1450 (801) 213-3900 Google Maps Apple Maps OpenStreetMap
Specialties
- Pediatrics 208000000X
- Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology 2084N0402X · Primary
In this directory
ID Bonneville County Idaho Falls Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology
Locations and evidence
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Practice location
IDAHO FALLS, ID, 834023169
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.