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General NPI Number Information
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NPI Number | 1003152208
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Entity Type | Organization
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Legal Business Name | TRISTAR GYNECOLOGY ONCOLOGY, LLC
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Dates
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Enumeration Date | 12/17/2012
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Last Update Date | 09/15/2016
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Provider Practice Location Address
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Address Line | 330 23RD AVE N SUITE 600
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City | NASHVILLE
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State | TN
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Zip | 37203-1534
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Country | US
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Telephone | 615-340-4640
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Fax | 615-340-4642
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Provider Business Mailing Address
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Address Line | 330 23RD AVE N SUITE 600
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City | NASHVILLE
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State | TN
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Zip | 37203-1534
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Country | US
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Telephone | 615-340-4640
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Fax | 615-340-4642
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | DAN SYKES
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Credential |
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Telephone | 615-342-6878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number |
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License Number State | TN
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