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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. LEROY TAYLOR KINCANNON III, O.D.

Active

DR. LEROY TAYLOR KINCANNON III, O.D. is a Optometrist healthcare provider located in GRAND RAPIDS, Minnesota. NPI 1528173846 is currently active in the NPPES registry. Verify at CMS.

Optometrist · GRAND RAPIDS, MN

Registration Details

NPI Number
1528173846
Provider Type
Individual
Gender
Male
NPI Issued
Aug 19, 2006 (20.021129657485 yrs)
Last Updated
Jul 8, 2007
License
2466 (MN)

Practice Information

Address
1542 GOLF COURSE RD
SUITE 201
GRAND RAPIDS, MN, 557449603
Browse MN providers · Browse ZIP 55744
Phone
2183263433
Fax
2183263435
Primary Specialty
Optometrist
152W00000X

Other Optometrist Providers in GRAND RAPIDS, MN

Name Credential NPI
DR. DARWIN DALEN O.D. 1417954553
DR. RICHARD A PERROTT O.D. 1700968336
PAUL LEE DUBBELS O.D. 1235339953
LARRY JAMES SCHLAUDERAFF O.D. 1477748085
HEIDI DAHLBERG OD 1124289160
MR. MICHAEL C. YOUNG OD 1932434016
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.