Individual provider · Type 1 NPI

Jaceson Banham, PA-C

Physician Assistant · Idaho Falls, ID

NPI number 1295544344 Active

Practice location

1957 E 17th St
Idaho Falls, ID 83404-6429

Call (208) 523-1100 Map

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X8671842 (ID)

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 1295544344

Jaceson Banham, PA-C's National Provider Identifier is 1295544344, issued on Jan 3, 2025. 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 8, 2026.