Individual
JIM BOLENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3500 E FRANK PHILLIPS BLVD, BARTLESVILLE, OK 74006-2411
(918) 333-7200
Mailing address
4500 S GARNETT RD STE 300, TULSA, OK 74146-5238
(918) 728-6145
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
15357
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100089780A
—
OK
01
—
160551100
FIRSTCARE
—
05
—
194934902
—
TX
05
—
200664160A
—
KS
05
—
89305078
—
NM
01
—
8BD830
BCBSTX
TX
Enumeration date
04/27/2006
Last updated
03/29/2017
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