# TRI STATE UROLOGIC SERVICES PSC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** THE UROLOGY GROUP
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730372426
- **Authorized official:** EARL L WALZ (COO)
- **Authorized official phone:** (513) 366-4000

## Contact information

- **Practice address:** 10058 COOLEY RD, BROOKVILLE, IN 47012-9509
- **Practice address phone:** (513) 366-4000
- **Practice address fax:** (513) 366-4001
- **Mailing address:** 4700 SMITH RD, SUITE L, CINCINNATI, OH 45212-2787
- **Mailing address phone:** (513) 366-4000
- **Mailing address fax:** (513) 366-4001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/25/2007
- **Last updated:** 08/25/2007