Healthcare Provider Details

I. General information

NPI: 1639512213
Provider Name (Legal Business Name): TRIHEALTH PHYSICIANS OF INDIANA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2013
Last Update Date: 12/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 ELM ST SUITE 310
LAWRENCEBURG IN
47025-2048
US

IV. Provider business mailing address

98 ELM ST SUITE 310
LAWRENCEBURG IN
47025-2048
US

V. Phone/Fax

Practice location:
  • Phone: 812-537-5558
  • Fax: 812-537-1657
Mailing address:
  • Phone: 812-537-5558
  • Fax: 812-537-1657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: BRIAN KRAUSE
Title or Position: VICE PRESIDENT
Credential:
Phone: 513-569-5126