Stout, Eric Cameron

Stout, Eric Cameron is an sole proprietor health care provider with primary practice located at 2500 Starling St Ste 305 , Brunswick GA 31520-4265. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Stout, Eric Cameron can be contacted via phone (912) 554-0542.

Contact Information

Primary practice address
2500 Starling St Ste 305 Brunswick GA 31520-4265
Phone: (912) 554-0542
Fax: (912) 554-0475
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 056629 Georgia

Profile Details

NPI number 1730296112
LBN Legal business name Stout, Eric Cameron
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 23rd, 2006
Last updated Feb 23rd, 2016 - about 8 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 1730296112 NPPES
Georgia Other 20-3106721 TAX ID
Georgia MEDICAID 660215053A TAX ID

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