Jaceson Banham, PA-C

NPI 1295544344 · on the registry since 2025

Practice

Address: 1957 E 17th St
Idaho Falls, ID 83404
Phone: (208) 523-1100
Organisation at this address: Teton Cancer Institute
Teton Cancer Institute
Idaho Falls Recovery Center
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 7

Registry record

Primary taxonomy: Physician Assistant
363A00000X
Licence states on file: ID
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2026-06-08

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