Provider Demographics
NPI:1831500891
Name:TRIHEALTH PHYSICIANS OF INDIANA, INC
Entity Type:Organization
Organization Name:TRIHEALTH PHYSICIANS OF INDIANA, INC
Other - Org Name:TRIHEALTH ORTHO AND SPINE INSTITUTE
Other - Org Type:Doing Business As
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:513-853-4940
Practice Address - Street 1:256 S. STATE ROUTE 129
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-9236
Practice Address - Country:US
Practice Address - Phone:812-934-6428
Practice Address - Fax:812-934-6122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-13
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201163730CMedicaid