# ALLERGY AND ASTHMA ASSOCIATES OF TRI-STATE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043444755
- **Authorized official:** DR. MYTHILI GURRAM M.D.,F.A.C.A.A.I (OWNER)
- **Authorized official phone:** (812) 491-1307

## Contact information

- **Practice address:** 827 S GREEN RIVER RD, EVANSVILLE, IN 47715-4105
- **Practice address phone:** (812) 491-1307
- **Practice address fax:** (812) 473-7226
- **Mailing address:** PO BOX 3276, EVANSVILLE, IN 47731-3276
- **Mailing address phone:** (812) 473-0181
- **Mailing address fax:** (812) 473-5822

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | — | NULL | Yes |
| 207K00000X | Allergy & Immunology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/08/2009
- **Last updated:** 07/14/2021