Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 3496 | OK |
NPI | 1013984251 |
---|---|
Provider Name | Dr. Wesley M Stotler |
First Address | Tulsa, OK 74146 |
Second Address | Tulsa, OK 74146-5822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 27/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100108290A | (05) | OK |
200045047 | RAILROAD MEDICARE (01) | OK |
H43553 | (02) |