Organization
TRI-STATE EAR, NOSE, AND THROAT SURGEONS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID T. WAHLE M.D. (PRESIDENT)
(812) 425-4646
Entity
Organization
Contact information
Practice address
350 W COLUMBIA ST, SUITE 310, EVANSVILLE, IN 47710-1782
(812) 425-4646
(812) 467-7209
Mailing address
350 W COLUMBIA ST, SUITE 310, EVANSVILLE, IN 47710-1782
(812) 425-4646
(812) 467-7209
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
50001145A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100241980
—
IN
Enumeration date
01/26/2006
Last updated
09/11/2014
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