Provider Demographics
NPI:1477920288
Name:TRI-STATE CENTERS FOR SIGHT INC
Entity type:Organization
Organization Name:TRI-STATE CENTERS FOR SIGHT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:NORDLOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-344-2061
Mailing Address - Street 1:2865 CHANCELLOR DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3912
Mailing Address - Country:US
Mailing Address - Phone:859-344-2079
Mailing Address - Fax:859-581-7207
Practice Address - Street 1:8211 CORNELL RD
Practice Address - Street 2:SUITE 510
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-2273
Practice Address - Country:US
Practice Address - Phone:513-791-5999
Practice Address - Fax:513-791-4567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty