Provider Demographics
NPI:1043191679
Name:KYNDL HEALTH
Entity type:Organization
Organization Name:KYNDL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TANNER
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:TOLLETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-963-9309
Mailing Address - Street 1:PO BOX 372
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:CO
Mailing Address - Zip Code:80135-0372
Mailing Address - Country:US
Mailing Address - Phone:512-963-9309
Mailing Address - Fax:
Practice Address - Street 1:834 S PERRY ST STE F
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1941
Practice Address - Country:US
Practice Address - Phone:512-963-9309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty