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 1:201 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:MOUND VALLEY
Mailing Address - State:KS
Mailing Address - Zip Code:67354-9317
Mailing Address - Country:US
Mailing Address - Phone:515-661-7729
Mailing Address - Fax:
Practice Address - Street 1:201 E 9TH ST
Practice Address - Street 2:
Practice Address - City:MOUND VALLEY
Practice Address - State:KS
Practice Address - Zip Code:67354
Practice Address - Country:US
Practice Address - Phone:515-661-7729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018014203207P00000X, 207Q00000X
OK8460207Q00000X
KS05-36412207Q00000X
TXS4603207Q00000X
MI390200000X
IAR-9239390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program