Organization
TRI STATE UROLOGIC SERVICES PSC INC
Active
Other names
THE UROLOGY GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
EARL L WALZ (CEO)
(513) 841-7400
Entity
Organization
Contact information
Practice address
925 DEIS DR, FAIRFIELD, OH 45014-8130
(513) 841-7900
(513) 841-7901
Mailing address
2000 JOSEPH E SANKER BLVD, CINCINNATI, OH 45212-1979
(513) 841-7400
(513) 841-7402
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0276946
—
OH
01
—
CC2433
RAILROAD MEDICARE
OH
Enumeration date
09/01/2009
Last updated
03/09/2026
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