Provider Demographics
NPI:1518381797
Name:TRIHEALTH PHYSICIAN OF INDIANA, INC
Entity Type:Organization
Organization Name:TRIHEALTH PHYSICIAN OF INDIANA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. VP CORP COUNSEL
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:NIENABER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-569-6062
Mailing Address - Street 1:PO BOX 638224
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-8224
Mailing Address - Country:US
Mailing Address - Phone:513-853-4749
Mailing Address - Fax:513-853-4740
Practice Address - Street 1:600 WILSON CREEK RD
Practice Address - Street 2:SUITE 310
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-2751
Practice Address - Country:US
Practice Address - Phone:513-922-4810
Practice Address - Fax:513-922-3421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-10
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty