Provider Demographics
NPI:1811212202
Name:BOND, TREVOR LYNN (DO)
Entity Type:Individual
Prefix:
First Name:TREVOR
Middle Name:LYNN
Last Name:BOND
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:PO BOX 1714
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1714
Mailing Address - Country:US
Mailing Address - Phone:515-643-4610
Mailing Address - Fax:515-643-4622
Practice Address - Street 1:250 LAUREL ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3024
Practice Address - Country:US
Practice Address - Phone:515-643-4690
Practice Address - Fax:515-643-4662
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-9239390200000X
MI390200000X
KS05-36412207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program