IndividualActive
Jason Davis, PA
NPI 1003127374 · Physician Assistant · Gooding, ID
Provider details
- NPI number
- 1003127374
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- License
- PA06785 (TX)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
267 N Canyon Dr
Gooding, ID 83330-5500
Phone: (208) 934-4446
Fax: (208) 934-4442
Approximate (ZIP-level) locationGet directions
Mailing address
267 N Canyon Dr
Gooding, ID 83330-5500
Registry dates
- Enumerated
- 2010-07-01
- Last updated
- 2022-08-26
- Certified
- 2022-08-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.