Provider Demographics
NPI:1598821936
Name:TRI RIVERS SURGICAL ASSOCIATES, INC.
Entity Type:Organization
Organization Name:TRI RIVERS SURGICAL ASSOCIATES, INC.
Other - Org Name:BUTLER BONE & JOINT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:D.
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:AGNEW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-367-0600
Mailing Address - Street 1:9104 BABCOCK BLVD
Mailing Address - Street 2:SUITE 2120
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5818
Mailing Address - Country:US
Mailing Address - Phone:412-367-0600
Mailing Address - Fax:
Practice Address - Street 1:142 CLEARVIEW CIR
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-1565
Practice Address - Country:US
Practice Address - Phone:412-367-0600
Practice Address - Fax:412-367-7079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA031687Medicare PIN