Individual provider · Type 1 NPI

Ariel Shantay Avis Taysom, PA-C

Physician Assistant · Malad City, ID

NPI number 1609341098 Active

Practice location

220 Bannock St
Malad City, ID 83252-5068

Fax (208) 766-4258

Specialties and licenses

Taxonomy	Code	License
Physician Assistant Primary	363A00000X	PA-1656 (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 1609341098

Ariel Shantay Avis Taysom, PA-C's National Provider Identifier is 1609341098, issued on Oct 11, 2018. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Malad City, ID. The record was last updated on Nov 16, 2021.