Healthcare Provider Details

I. General information

NPI: 1699762260
Provider Name (Legal Business Name): TRISTATE HOME PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8351 COUNTRY OAKS STA
WEST CHESTER OH
45069-2769
US

IV. Provider business mailing address

8351 COUNTRY OAKS STA
WEST CHESTER OH
45069-2769
US

V. Phone/Fax

Practice location:
  • Phone: 513-759-9018
  • Fax:
Mailing address:
  • Phone: 513-759-9018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number35-07-5321-A
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number35-07-5321A
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number34820
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number34820
License Number StateKY

VIII. Authorized Official

Name: DR. ORDUEN ABUNKU
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 513-759-9018