Organization
TULSA COLON AND RECTAL SURGERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT A FENGLER MD (SECRETARY TREASURER)
(918) 294-4788
Entity
Organization
Contact information
Practice address
4735 E 91ST, 200, TULSA, OK 74137-2804
(918) 794-4788
(918) 794-4789
Mailing address
4735 E 91ST, 200, TULSA, OK 74137-2804
(918) 794-4788
(918) 794-4789
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C54766
UNITED HEALTHCARE RR MC
—
Enumeration date
12/11/2006
Last updated
08/22/2020
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