Provider Demographics
NPI:1669742433
Name:NORTHPOINT RADIATION CENTER GP LLC
Entity type:Organization
Organization Name:NORTHPOINT RADIATION CENTER GP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:D
Authorized Official - Last Name:TRYGGESTAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-364-7880
Mailing Address - Street 1:PO BOX 678083
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-8083
Mailing Address - Country:US
Mailing Address - Phone:469-364-7880
Mailing Address - Fax:469-364-7834
Practice Address - Street 1:2526 PINNACLE HILLS PKWY
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8939
Practice Address - Country:US
Practice Address - Phone:469-364-7880
Practice Address - Fax:469-364-7834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC61522085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty