Organization
TRI-STATE ORTHOPAEDIC SURGEONS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP RAWLEY MBA (CEO)
(812) 477-1558
Entity
Organization
Contact information
Practice address
225 CROSSLAKE DR, EVANSVILLE, IN 47715-8198
(812) 477-1558
Mailing address
225 CROSSLAKE DR, EVANSVILLE, IN 47715-8198
(812) 477-1558
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
50000637A
IN
208100000X
Physical Medicine & Rehabilitation Physician
—
—
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000071424
ANTHEM
IN
05
—
100241560A
—
IN
01
—
123637
HEALTHLINK
—
Enumeration date
10/13/2005
Last updated
10/04/2019
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