Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Craig Stephen Kantack, PA-C

Individual provider Medical Physician Assistant · NPI 1699052357

Mr. Craig Stephen Kantack, PA-C is a Medical Physician Assistant in Idaho Falls, Idaho. Licensed in Idaho. Registered with an NPI since 2011.

Licensed in
ID
In the registry since
2011
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

740 S Woodruff Ave
Idaho Falls, ID 83401-5285
Phone: (208) 542-9111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA-984 (ID)

Record details

NPI number1699052357
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 9, 2011
Last updated in NPPESApril 12, 2023
Certification dateApril 12, 2023

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