Provider Demographics
NPI:1083692321
Name:TRINITY ANESTHESIOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:TRINITY ANESTHESIOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN OF ANESTHESIA DEPT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:WALTHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-264-9610
Mailing Address - Street 1:PO BOX 669
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-5669
Mailing Address - Country:US
Mailing Address - Phone:740-264-9610
Mailing Address - Fax:740-266-7004
Practice Address - Street 1:4000 JOHNSON RD
Practice Address - Street 2:ANESTHESIA DEPT
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2300
Practice Address - Country:US
Practice Address - Phone:740-264-9610
Practice Address - Fax:740-266-7004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-06
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2355795Medicaid
WV0240064-000Medicare ID - Type Unspecified
OH2355795Medicaid