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NPI Code Detail

MEDICARE: TRI-STATE CENTERS FOR SIGHT, INC.

MEDICARE: TRI-STATE CENTERS FOR SIGHT, INC.
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
1207W00000XOphthalmology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053659839
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRI-STATE CENTERS FOR SIGHT, INC.
Provider Business Mailing Address
First Line : 2865 CHANCELLOR DR
Second Line : SUITE 215
City : CRESTVIEW HILLS
State : KY
Zip : 41017-3912
Country : US
Telephone Number : 859-581-7120
Fax Number : 859-581-7207
Provider Business Practice Location Address
First Line : 7527 STATE RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45255-6407
Country : US
Telephone Number : 513-381-1900
Fax Number : 513-287-6403
Authorized Official
Title or Position : CEO
Name : DANIEL A NORDLOH
Credential :
Telephone Number : 859-344-2061
Provider Enumeration Date : 01/29/2013
Last Update Date : 10/13/2015

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Directions to “TRI-STATE CENTERS FOR SIGHT, INC. ” Practice Location

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