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Gordon Gary Koltis, MD
Therapeutic Radiology Physician in Greenville, North Carolina
NPI 1508860545

Gordon Gary Koltis is a Therapeutic Radiology Physician based in Fort Myers, NC and is specialized in Therapeutic Radiology. Gordon Gary Koltis practices in Greenville, NC and has the professional credentials of MD. The NPI Number for Gordon Gary Koltis is 1508860545 and holds a License No. 33390 (North Carolina).

The current practice location address for Gordon Gary Koltis is 801 W H Smith Blvd, Greenville, NC and can be reached out via phone at 252-329-0025 and via fax at 252-329-0325. You can also correspond with Gordon Gary Koltis through the mailing address at 2234 COLONIAL BLVD, FORT MYERS, FL - 33907-1412 (mailing address contact number: 239-931-7342).

Location: 801 W H Smith Blvd, Greenville, NC, 33907-1412
person
Provider Profile Details
NPI Number
1508860545
Provider Name
Gordon Gary Koltis
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
801 W H Smith Blvd, Greenville, NC, 33907-1412
Phone Number
252-329-0025
Fax Number
252-329-0325
Provider Enumeration Date
06/08/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
49898 01 NC BCBS
24-00059 01 NC UNITED HEALTHCARE
9421363-001 01 NC CIGNA
P00612668 01 NC RAILROAD MEDICARE PTAN
8949898 05 NC
30013692 01 NC RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
801 W H Smith Blvd
City
State
Zip
27834-3764
Phone Number
252-329-0025
Fax Number
252-329-0325
person
Provider Business Mailing Address Details
Address
2234 Colonial Blvd
City
State
Zip
33907-1412
Phone Number
239-931-7342
Fax Number
239-931-7385
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Radiation Oncology
Taxonomy
License No.
G86259 (California)
Definition
A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Therapeutic Radiology
Taxonomy
License No.
33390 (North Carolina)
Definition
Definition to come...
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