Provider Demographics
NPI:1235318262
Name:TRI COUNTY SURGERY LLC
Entity Type:Organization
Organization Name:TRI COUNTY SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BATTAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-557-3503
Mailing Address - Street 1:PO BOX 59
Mailing Address - Street 2:1061 BRUNSWICK DR
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45118-0059
Mailing Address - Country:US
Mailing Address - Phone:513-557-3503
Mailing Address - Fax:
Practice Address - Street 1:1061 BRUNSWICK DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45118-9440
Practice Address - Country:US
Practice Address - Phone:513-875-4592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
020051906Medicare PIN
G88313Medicare UPIN