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Contact Information

JASON L COTTRELL, PA
777 HOSPITAL WAY
SUITE 101
POCATELLO, ID83201-5175
 Phone: 208-239-3899
 Fax: 208-232-2195
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Pharmacy Technician

183700000X
Indicates primary specialty

NPI Profile & details for JASON L COTTRELL · (Male)

NPI Number 1265115547
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 08/11/2023
Last updated 10/27/2025 - About 7 months ago
Sole proprietor 1 No
Identifiers
  • ID License # 9071482
  • ID License # CT66258
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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