Healthcare Provider Details

I. General information

NPI: 1821431081
Provider Name (Legal Business Name): TREVOR KITCHIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2013
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 POLARIS PKWY STE 100
WESTERVILLE OH
43082-6090
US

IV. Provider business mailing address

460 POLARIS PKWY STE 100
WESTERVILLE OH
43082-6090
US

V. Phone/Fax

Practice location:
  • Phone: 614-895-3344
  • Fax: 614-895-3795
Mailing address:
  • Phone: 614-895-3344
  • Fax: 614-895-3795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number35127124
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: