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Organization

TRI STATE DIAGNOSTIC SERVICES , INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES KENNEALY MD (MD: AUTHORIZED SIGNATORY)
(513) 451-1930
Entity
Organization

Contact information

Practice address
2446 KIPLING AVE, CINCINNATI, OH 45239-6650
(513) 853-5000
Mailing address
PO BOX 932321, CLEVELAND, OH 44193-0001
(513) 853-5000

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0918654
OH
05
0922283
OH
Enumeration date
05/08/2006
Last updated
08/19/2011
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