Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Leroy Taylor Kincannon III, OD

Individual provider Optometrist · NPI 1528173846

Dr. Leroy Taylor Kincannon III, OD is an Optometrist in Grand Rapids, Minnesota. Licensed in Minnesota. Registered with an NPI since 2006.

Licensed in
MN
In the registry since
2006
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

1542 Golf Course Rd Ste 201
Grand Rapids, MN 55744-9603
Phone: (218) 326-3433
Fax: (218) 326-3435
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 2466 (MN)

Record details

NPI number1528173846
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedAugust 19, 2006
Last updated in NPPESJuly 8, 2007

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