Organization Name: | TRI-STATE PEDIATRICS |
NPI Number: | 1013098904 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHELLE ELIZABETH SISLER (BILLING CLERK) |
Mailing Address: | 900 Saint Christopher Dr Building 4 Suite 101 Ashland |
State: | KY US |
Postal Code: | 411017090 |
Phone Number: | 6068360919 |
Fax Number: | 6068362847 |
NPI Enumeration Date: | 10/18/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 25781 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |