Healthcare Provider Details

I. General information

NPI: 1679903009
Provider Name (Legal Business Name): TRIHEALTH PHYSICIANS OF INDIANA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2013
Last Update Date: 11/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 WILSON CREEK RD SUITE 310
LAWRENCEBURG IN
47025-2751
US

IV. Provider business mailing address

PO BOX 638224
CINCINNATI OH
45263-8224
US

V. Phone/Fax

Practice location:
  • Phone: 513-961-4263
  • Fax: 513-961-1503
Mailing address:
  • Phone: 513-853-4731
  • Fax: 513-569-5199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number01039039B
License Number StateIN

VIII. Authorized Official

Name: MRS. DONNA NIENABER
Title or Position: SENIOR VP COUNSEL
Credential:
Phone: 513-569-6062