| Tri-state Telemed Llc | |
|
178 Private Road 19423 South Point OH 45680-8831 | |
| (304) 208-5978 | |
| Not Available |
| Full Name | Tri-state Telemed Llc |
|---|---|
| Speciality | General Practice |
| Location | 178 Private Road 19423, South Point, Ohio |
| Authorized Official Name and Position | Shannon Maxey (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3042085978 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri-state Telemed Llc 620 Private Road 19423 South Point OH 45680-9019 Ph: (304) 208-5978 | Tri-state Telemed Llc 178 Private Road 19423 South Point OH 45680-8831 Ph: (304) 208-5978 |
| NPI Number | 1093180903 |
|---|---|
| Provider Enumeration Date | 12/02/2015 |
| Last Update Date | 12/02/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093180903 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 48537 (Kentucky) | Primary |
| 363L00000X | Nurse Practitioner | 1121101 (Kentucky) | Secondary |
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