Stout, Alan

Stout, Alan is an individual health care provider with primary practice located at 612 N Patterson St , Valdosta GA 31601-4610. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Stout, Alan can be contacted via phone (706) 980-9975.

Contact Information

Primary practice address
612 N Patterson St Valdosta GA 31601-4610
Phone: (706) 980-9975
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 026664 Georgia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 026664 Georgia

Profile Details

NPI number 1205878386
LBN Legal business name Stout, Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Jul 24th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205878386 NPPES
Georgia MEDICAID 000320526G
Georgia MEDICAID 000320526H
Georgia Other P00282948
Georgia MEDICAID 000320526F
Georgia Other 4130194

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