Provider Demographics
NPI:1396914917
Name:PARKINSON, JASON ONEAL (DO)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:ONEAL
Last Name:PARKINSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8674B VOLCANO LOOP
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME AFB
Mailing Address - State:ID
Mailing Address - Zip Code:83648-5008
Mailing Address - Country:US
Mailing Address - Phone:570-594-9514
Mailing Address - Fax:
Practice Address - Street 1:1408 POMERELLE AVE
Practice Address - Street 2:SUITE H
Practice Address - City:BURLEY
Practice Address - State:ID
Practice Address - Zip Code:83318-2067
Practice Address - Country:US
Practice Address - Phone:208-677-6170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IDO-0831207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program