person
Jonathan B Pittard, PA-C
Medical Physician Assistant in Twin Falls, Idaho
NPI 1376876599

Jonathan B Pittard is a Medical Physician Assistant based in Twin Falls, ID and is specialized in Medical. Jonathan B Pittard practices in Twin Falls, ID and has the professional credentials of PA-C. The NPI Number for Jonathan B Pittard is 1376876599 and holds a License No. PA804 (Idaho).

The current practice location address for Jonathan B Pittard is 243 Cheney Dr W Ste 200, Twin Falls, ID and can be reached out via phone at 208-736-7422 and via fax at 208-736-8905.

Location: 243 Cheney Dr W Ste 200, Twin Falls, ID, 83301-4277
person
Provider Profile Details
NPI Number
1376876599
Provider Name
Jonathan B Pittard
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
243 Cheney Dr W Ste 200, Twin Falls, ID, 83301-4277
Phone Number
208-736-7422
Fax Number
208-736-8905
Provider Enumeration Date
09/08/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
PA804 01 ID LICENSE NUMBER
institution
Provider Business Practice Location Address Details
Address
243 Cheney Dr W Ste 200
City
State
Zip
83301-4278
Phone Number
208-736-7422
Fax Number
208-736-8905
person
Provider Business Mailing Address Details
Address
243 Cheney Dr W Ste 200
City
State
Zip
83301-4278
Phone Number
208-736-7422
Fax Number
208-736-8905
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA804 (Idaho)
Definition
Definition to come...
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