NPI age
17 years
Enumerated 2009-04-27
● Active Type 2 · Organization
Subpart
Teton Radiology Diagnostic, Llc
Teton Radiology Diagnostic, Llc is 1 of 7 radiology organizations in Idaho.
Primary specialty
Radiology
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Hodel
General Manager
Last NPPES update
2026-01-05
Source: monthly bulk 2026-05
How this organization compares
Across 7 active radiology providers in Idaho.
NPI age
17 years
≈ at median (17 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2009 → 2026
2009-04Enumerated in NPPES
2009
2026
Where they practice
Primary practice location
2001 S Woodruff Ave Ste 17
Idaho Falls, ID 834046372
Mailing address
Po Box 30015, Dept 594
Salt Lake City, UT 841300015
Authorized official
Michael P Hodel
General Manager
📞 2085425000
Specialties
-
Radiology PrimaryA Radiology doctor of Osteopathy that specializes in Body Imaging.
Practice context
Single-site organization. Only one practice location on file.
Subpart of Teton Radiology Diagnositc, Llc.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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