Healthcare Provider Details

I. General information

NPI: 1255408860
Provider Name (Legal Business Name): TRISTATE CENTERS FOR SIGHT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 READING RD SUITE 330
CINCINNATI OH
45202-1461
US

IV. Provider business mailing address

2865 CHANCELLOR DR STE 215
CRESTVIEW HILLS KY
41017-3931
US

V. Phone/Fax

Practice location:
  • Phone: 513-381-1900
  • Fax: 513-287-6403
Mailing address:
  • Phone: 859-331-1058
  • Fax: 513-791-4567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIEL A NORDLOH
Title or Position: ADMINISTRATOR
Credential:
Phone: 859-581-7120