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Organization

TRI-STATE SURGICAL CONSULTANTS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARTIN B POPP M.D. (OWNER)
(513) 421-4504
Entity
Organization

Contact information

Practice address
2123 AUBURN AVE STE 420, CINCINNATI, OH 45219-2906
(513) 421-4504
(513) 421-4507
Mailing address
2123 AUBURN AVE STE 420, CINCINNATI, OH 45219-2906
(513) 421-4504
(513) 421-4507

Taxonomy

Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
35-03-1878P
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100394580
EDS INDIANA MEDICAID
IN
Enumeration date
07/25/2007
Last updated
07/25/2007
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