Healthcare Provider Details

I. General information

NPI: 1760609887
Provider Name (Legal Business Name): TRI-STATE NEUROSURGICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W COLUMBIA ST STE 350
EVANSVILLE IN
47710-5610
US

IV. Provider business mailing address

350 W COLUMBIA ST STE 350
EVANSVILLE IN
47710-5610
US

V. Phone/Fax

Practice location:
  • Phone: 812-477-0900
  • Fax: 812-477-0099
Mailing address:
  • Phone: 812-477-0900
  • Fax: 812-477-0099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER SNEED
Title or Position: PRACTICE MANAGER
Credential: M.D.
Phone: 812-477-0900