Stout, Mark J
Stout, Mark J is an individual health care provider with primary practice located at 725 American Ave , Waukesha WI 53188-5031. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), Allopathic & Osteopathic Physicians / Transplant Surgery. Allopathic & Osteopathic Physicians / Transplant Surgery is his primary health care specialty. Stout, Mark J can be contacted via phone (608) 263-1530.Contact Information
Primary practice address
725 American Ave
Waukesha WI 53188-5031
Phone: (608) 263-1530
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 01069517A | Indiana |
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 62383 | Wisconsin |
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 036080105 | Illinois |
| Allopathic & Osteopathic Physicians / Transplant Surgery | 204F00000X | 62383 | Wisconsin |
Profile Details
| NPI number | 1851386551 |
|---|---|
| LBN Legal business name | Stout, Mark J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 19th, 2005 |
| Last updated | May 3rd, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851386551 | NPPES |
| Indiana | Other | P01027332 | RAILROAD MEDICARE |
| Indiana | Other | 000001005823 | RAILROAD MEDICARE |
| Indiana | MEDICAID | 036080105 | RAILROAD MEDICARE |
| Indiana | Other | 01605360 | RAILROAD MEDICARE |
| Indiana | MEDICAID | 201019900 | RAILROAD MEDICARE |
| Indiana | Other | 780000280 | RAILROAD MEDICARE |
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