Provider Demographics
NPI:1942609201
Name:SUNRISE RADIATION ONCOLOGY, PC
Entity Type:Organization
Organization Name:SUNRISE RADIATION ONCOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:JEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-715-2652
Mailing Address - Street 1:4704 HARLAN ST
Mailing Address - Street 2:SUITE 511
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-7415
Mailing Address - Country:US
Mailing Address - Phone:720-382-1008
Mailing Address - Fax:720-382-1012
Practice Address - Street 1:4700 HALE PKWY
Practice Address - Street 2:FOUNDERS BUILDING, STE 150
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-4045
Practice Address - Country:US
Practice Address - Phone:303-320-7006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-21
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.00541952085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty