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Individual

DR. KEITH B STOUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M. D.

Contact information

Practice address
3480 COLLEGE ST, BEAUMONT, TX 77701-4612
(409) 813-1677
(409) 730-1399
Mailing address
3480 COLLEGE ST, BEAUMONT, TX 77701-4612
(409) 813-1677
(409) 730-1399

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
E9428
TX
208D00000X
General Practice Physician
Primary
E9428
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
137850712
TX
Enumeration date
05/31/2005
Last updated
01/19/2016
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