Provider Demographics
NPI:1679565089
Name:LONE STAR ORTHOPAEDICS INC
Entity type:Organization
Organization Name:LONE STAR ORTHOPAEDICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:AMIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-751-3668
Mailing Address - Street 1:3219 CLIFTON AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45220-3045
Mailing Address - Country:US
Mailing Address - Phone:513-751-3368
Mailing Address - Fax:513-751-0023
Practice Address - Street 1:3219 CLIFTON AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-3045
Practice Address - Country:US
Practice Address - Phone:513-751-3368
Practice Address - Fax:513-751-0023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-22
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207XX0004X, 332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH124691100OtherUS DEPARTMENT OF LABOR
OH2149544Medicaid
OH000000038974OtherANTHEM
OH2149544Medicaid
OH=========00OtherWORKER COMPENSATION
0253680001Medicare NSC
CG1129Medicare PIN
OHL09303971Medicare PIN