Organization
UNION PINES SURGERY CENTER,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WESLEY STOTLER DO (MEDICAL DIRECTOR)
(918) 742-1457
Entity
Organization
Contact information
Practice address
4808 S 109TH EAST AVE, TULSA, OK 74146-5822
(918) 742-2502
(918) 745-9750
Mailing address
4808 S 109TH EAST AVE, TULSA, OK 74146-5822
(918) 742-2502
(918) 745-9750
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0015
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000371001 002
BC/BS
OK
01
—
8471141
AETNA
OK
Enumeration date
08/10/2005
Last updated
02/16/2026
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