Organization · Type 2 NPI
Jackson Taravine SR
Medical Physician Assistant · Chandler, AZ
NPI number
1467316042
Active
Practice location
1256 W Chandler Blvd Ste G
Chandler, AZ 85224-5208
Fax (480) 300-5840
Mailing address
15182 N 75th Ave Ste 180
Peoria, AZ 85381-4722
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | None listed |
Medical Physician Assistant: Definition to come...
Other medical physician assistant providers in Chandler
About NPI 1467316042
Jackson Taravine SR's National Provider Identifier is 1467316042, issued on Dec 9, 2025. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Chandler, AZ. The record was last updated on Mar 3, 2026.