Individual provider · Type 1 NPI

Kenneth William Jackson, PA

Physician Assistant · Idaho Falls, ID

NPI number 1194587824 Active

Practice location

3200 Channing Way Ste A206
Idaho Falls, ID 83404-7586

Call (208) 529-2230 Map

Fax (208) 561-8061

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X7871497 (ID)
Physician Assistant 363A00000XTC075 (KY)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1194587824

Kenneth William Jackson, PA's National Provider Identifier is 1194587824, issued on Jan 29, 2024. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Idaho Falls, ID. The record was last updated on Jun 9, 2026.