Provider Demographics
NPI:1578690780
Name:TRI-STATE ARTHRITIS & RHEUMATOLOGY CENTER, LLC
Entity Type:Organization
Organization Name:TRI-STATE ARTHRITIS & RHEUMATOLOGY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:EARNEST
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-437-2330
Mailing Address - Street 1:3801 BELLEMEADE AVE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-0100
Mailing Address - Country:US
Mailing Address - Phone:812-437-2330
Mailing Address - Fax:812-437-2335
Practice Address - Street 1:3801 BELLEMEADE AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0100
Practice Address - Country:US
Practice Address - Phone:812-437-2330
Practice Address - Fax:812-437-2335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01036711A207RR0500X
IN01053981A207RR0500X
IN01059296A207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IND47008Medicare UPIN
ING86153Medicare UPIN
ING52503Medicare UPIN
IN189780DMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER