Organization
TRI-STATE PAIN MANAGEMENT SERVICE INC
Active
Organization
TRI-STATE PAIN MANAGEMENT SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAIRAM L ATLURI MD (PRESIDENT OWNER)
(859) 341-7246
Entity
Organization
Contact information
Practice address
3000 HOSPITAL DR, BATAVIA, OH 45103-1921
(859) 341-7246
(859) 341-7867
Mailing address
# L-6067, CINCINNATI, OH 45270-0001
(859) 341-7246
(859) 341-7867
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000388145
ANTHEM
—
05
—
200377720
—
IN
05
—
2044773
—
OH
01
—
284941995
HEALTHNET
—
01
—
28494199500
BUREAU OF WORKERS COMP
—
01
—
5124498
CIGNA
—
05
—
65944233
—
KY
01
—
728014
BUCKEYE
—
Enumeration date
04/14/2010
Last updated
04/14/2010
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