Individual provider · Type 1 NPI

Grant Jacobsen

Vascular & Interventional Radiology Physician · Boise, ID

NPI number 1306647581 Active

Practice location

500 W Fort St # 111R
Boise, ID 83702-4599

Call (208) 422-1000 Map

Specialties and licenses

TaxonomyCodeLicense
Internal Medicine Physician 207R00000X7271468 (ID)
Vascular & Interventional Radiology Physician Primary 2085R0204XMDRE.ML.70106827 (WA)

Vascular & Interventional Radiology Physician: A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.

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About NPI 1306647581

Grant Jacobsen's National Provider Identifier is 1306647581, issued on Mar 22, 2025. The primary taxonomy on file is Vascular & Interventional Radiology Physician (2085R0204X), and the practice location is in Boise, ID. The record was last updated on Jun 25, 2026.