John David McDermott, P.A.

Physician Assistant · Eagle, ID

Individual Active NPI

NPI number 1689627069

Practice location

3101 E State St
Suite 2120
Eagle, ID 83616
Phone
(208) 473-3275

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NPI record

NPI
1689627069
Entity type
Individual (Type 1)
Enumeration date
May 18, 2006
Last updated
September 4, 2012
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X PRA103 ID

Mailing address

190 E Bannock St
Boise, ID 83712-6241
Phone
(208) 381-2222

About John McDermott

John David McDermott, P.A. is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 3101 E State St, Suite 2120, Eagle, ID 83616. The NPI number 1689627069 was assigned on May 18, 2006 and the record was last updated on September 4, 2012.

John McDermott lists a license in the registry: #PRA103 (ID) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of John David McDermott, P.A.?

The NPI number is 1689627069.

What is the phone number of John McDermott?

The phone number listed for the practice location is (208) 473-3275.

Where is John McDermott located?

3101 E State St, Suite 2120, Eagle, ID 83616.

What is the taxonomy code for John McDermott?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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