Healthcare Provider Details

I. General information

NPI: 1811212202
Provider Name (Legal Business Name): TREVOR LYNN BOND D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E 9TH ST
MOUND VALLEY KS
67354
US

IV. Provider business mailing address

201 E 9TH ST
MOUND VALLEY KS
67354-9317
US

V. Phone/Fax

Practice location:
  • Phone: 515-661-7729
  • Fax:
Mailing address:
  • Phone: 515-661-7729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberR-9239
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2018014203
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number8460
License Number StateOK
# 5
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number05-36412
License Number StateKS
# 6
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberS4603
License Number StateTX
# 7
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2018014203
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: