Jared Wilson, PA-C, MPAS, MED, ATC

NPI 1275748089 · on the registry since 2007

Practice

Address: 777 Hospital Way
South Mob, Suite 204
Pocatello, ID 83201
Phone: (208) 239-2110
Fax: (208) 239-2119
Organisation at this address: Cds,Pa
Rcp Inc
Bmh Inc.
Cep America Llc
Teton Spine, Pllc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 143

Registry record

Primary taxonomy: 363AS0400X
363AS0400X
Also registered as: 2255A2300X
Licence states on file: ID
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2025-08-03

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