Organization
TRI-STATE OPHTHALMOLOGY ASSOCIATES PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN C GROSS MD (PRESIDENT)
(606) 324-2451
Entity
Organization
Contact information
Practice address
2841 LEXINGTON AVE, ASHLAND, KY 41101-3009
(606) 324-2451
(606) 324-7123
Mailing address
2841 LEXINGTON AVENUE, ASHLAND, KY 41101
(606) 324-2451
(606) 324-7123
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2115848
—
OH
05
—
65931172
—
KY
01
—
CA4418
MEDICARE RAILROAD
KY
Enumeration date
07/05/2006
Last updated
12/05/2022
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