Provider Demographics
NPI:1184689572
Name:SIRA RADIATION ONCOLOGY ASSOCIATES LLC
Entity Type:Organization
Organization Name:SIRA RADIATION ONCOLOGY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BHARATI
Authorized Official - Middle Name:
Authorized Official - Last Name:KHARKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-332-8242
Mailing Address - Street 1:PO BOX 4366
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47402-4366
Mailing Address - Country:US
Mailing Address - Phone:812-332-8242
Mailing Address - Fax:812-333-7684
Practice Address - Street 1:2620 COTA DRIVE
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-4211
Practice Address - Country:US
Practice Address - Phone:812-332-8242
Practice Address - Fax:812-333-7684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200509750Medicaid
IN200509750Medicaid