Provider Demographics
NPI:1952652414
Name:TRISTAR RADIATION ONCOLOGY, LLC
Entity Type:Organization
Organization Name:TRISTAR RADIATION ONCOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SYKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-342-6878
Mailing Address - Street 1:2410 PATTERSON ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1551
Mailing Address - Country:US
Mailing Address - Phone:615-342-4850
Mailing Address - Fax:
Practice Address - Street 1:2410 PATTERSON ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1551
Practice Address - Country:US
Practice Address - Phone:615-342-4850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-25
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
No261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, RadiationGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty