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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
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982008611
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 : 500 THOMAS MORE PKWY
Second Line :
City : CRESTVIEW HILLS
State : KY
Zip : 41017-3454
Country : US
Telephone Number : 859-341-4525
Fax Number : 859-341-4993
Authorized Official
Title or Position : CHIEF REVENUE CYCLE OFFICER
Name : CANDICE B DAVIS
Credential :
Telephone Number : 916-990-7590
Provider Enumeration Date : 10/09/2014
Last Update Date : 02/12/2024

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

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