Individual provider · Type 1 NPI

Jacob Shane Tebbs, PA-C

Medical Physician Assistant · Boise, ID

NPI number 1154870251 Active

Practice location

6051 N Eagle Rd
Boise, ID 83713-0997

Fax (208) 205-9134

Mailing address

1900 N State St
Provo, UT 84604-1305

Other practice locations

  • 999 N Curtis Rd Ste 307, Boise, ID 83706-1333 · (208) 519-4333

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X10103875-1206 (UT)

Medical Physician Assistant: Definition to come...

8 other providers at this address

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About NPI 1154870251

Jacob Shane Tebbs, PA-C's National Provider Identifier is 1154870251, issued on Sep 29, 2016. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Boise, ID. The record was last updated on Aug 7, 2020.