Healthcare Provider Details

I. General information

NPI: 1184689572
Provider Name (Legal Business Name): SIRA RADIATION ONCOLOGY ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 12/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 COTA DRIVE
BLOOMINGTON IN
47403-4211
US

IV. Provider business mailing address

PO BOX 4366
BLOOMINGTON IN
47402-4366
US

V. Phone/Fax

Practice location:
  • Phone: 812-332-8242
  • Fax: 812-333-7684
Mailing address:
  • Phone: 812-332-8242
  • Fax: 812-333-7684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BHARATI KHARKAR
Title or Position: PRESIDENT
Credential: MD
Phone: 812-332-8242