IndividualActive
Jacob Radil, PA-C
NPI 1811337017 · Surgical Physician Assistant · Meridian, ID
Provider details
- NPI number
- 1811337017
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- LMSW # 33052 (ID)
Practice location
520 S Eagle Rd Ste 1243
Meridian, ID 83642-6355
Phone: (208) 333-2225
Fax: (208) 706-7516
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Registry dates
- Enumerated
- 2013-07-02
- Last updated
- 2022-01-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.