Individual
DR. WESLEY J DEROSIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5350 E 31ST ST STE 302, TULSA, OK 74135-5008
(918) 933-4085
(918) 779-7794
Mailing address
1001 N GRAND AVE, TAHLEQUAH, OK 74464-7017
(918) 456-5511
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2185
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100769300A
—
OK
Enumeration date
07/19/2006
Last updated
07/05/2019
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