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

Eagle Rock Regional Neurology, PC

Organization Neurology Physician · NPI 1710053756

Eagle Rock Regional Neurology, PC provides Neurology Physician services in Idaho Falls, Idaho. Licensed in Idaho. Registered with an NPI since 2006.

Licensed in
ID
In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1995 E 17th St Ste 5
Idaho Falls, ID 83404-6493
Phone: (208) 552-5700
Fax: (208) 552-5703
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X · Licence O343 (ID)

Record details

NPI number1710053756
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official William Domarad — Physician · (208) 552-5700
NPI enumeratedNovember 28, 2006
Last updated in NPPESAugust 22, 2020
Mailing address1995 E 17th St, Ste 5, Idaho Falls, ID 83404-6493

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