Healthcare Provider Details

I. General information

NPI: 1275601254
Provider Name (Legal Business Name): TRI-STATE CENTERS FOR SIGHT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1577B GOODMAN AVE
CINCINNATI OH
45224
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 513-729-1321
  • Fax: 513-729-2873
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