Provider Demographics
NPI:1033536107
Name:TRI-STATE ORTHOPAEDICS, LLC
Entity Type:Organization
Organization Name:TRI-STATE ORTHOPAEDICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LENGYEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-333-2525
Mailing Address - Street 1:PO BOX 38539
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38183-0539
Mailing Address - Country:US
Mailing Address - Phone:901-333-2525
Mailing Address - Fax:901-786-6635
Practice Address - Street 1:7656 POPLAR PIKE
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-5941
Practice Address - Country:US
Practice Address - Phone:901-333-2525
Practice Address - Fax:901-786-6635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty