Organization
TRI-STATE ANESTHESIA GROUP PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY C SHY (ADMINISTRATOR)
(304) 429-1088
Entity
Organization
Contact information
Practice address
2301 LEXINGTON AVE, SUITE 100, ASHLAND, KY 41101-2873
(304) 429-1088
(304) 429-3109
Mailing address
PO BOX 390, HUNTINGTON, WV 25708-0390
(304) 429-1088
(304) 429-3109
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
12/04/2014
Last updated
12/04/2014
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