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Search › Idaho › 163WX0800X

Lyle Jackson, CRNA

NPI 1225597305 · on the registry since 2019 · sole proprietor

Practice

Address
2325 Coronado St
Idaho Falls, ID 83404
Phone
(208) 557-2700
Organisation at this address
Macieski Crna Pc
Mvh Anesthesia, Llc
John G Foster Crna Pc
Prescription Center, Llc
Eagle Rock Anesthesia Pllc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
46

Registry record

Primary taxonomy
163WX0800X
163WX0800X
Also registered as
367500000X
367500000X
Licence states on file
VA, IA, ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-06-30

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho