Provider Demographics
NPI:1841290392
Name:BOND, KEVIN H (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:H
Last Name:BOND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-1920
Mailing Address - Country:US
Mailing Address - Phone:662-327-2921
Mailing Address - Fax:662-327-0552
Practice Address - Street 1:321 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-1920
Practice Address - Country:US
Practice Address - Phone:662-327-2921
Practice Address - Fax:662-327-0552
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS12474208800000X
AL21456207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00110746Medicaid
730-19417OtherBLUE CROSS AL
AL109118Medicaid
P00725467OtherRAILROAD MEDICARE
P00725467OtherRAILROAD MEDICARE
E66057Medicare UPIN