MEDICARE: TREVOR KINDLE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	33696	NE
2	207W00000X	Ophthalmology Physician	64021	MN
3	207W00000X	Ophthalmology Physician	12801	SD

General Provider Information

NPI Number	:	1548794316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TREVOR KINDLE

Provider Business Mailing Address
First Line	:	409 SUMMIT ST STE 3400
Second Line	:
City	:	YANKTON
State	:	SD
Zip	:	57078-3735
Country	:	US
Telephone Number	:	605-655-1830
Fax Number	:	605-655-1840

Provider Business Practice Location Address
First Line	:	409 SUMMIT ST STE 3400
Second Line	:
City	:	YANKTON
State	:	SD
Zip	:	57078-3735
Country	:	US
Telephone Number	:	605-655-1830
Fax Number	:	605-655-1840

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2017
Last Update Date	:	02/12/2026

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Directions to “ TREVOR KINDLE ” Practice Location

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