Organization
FIDELIS RADIOLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT H KOLMAN M.D. (PRESIDENT)
(918) 392-0720
Entity
Organization
Contact information
Practice address
7718 E 91ST ST, SUITE 220, TULSA, OK 74133-6045
(918) 392-0720
Mailing address
P.O. BOX 702586, TULSA, OK 74170
(918) 392-0720
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100739530A
—
OK
01
—
DE8794
RAILROAD MEDICARE
OK
Enumeration date
05/03/2007
Last updated
04/25/2012
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