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JEFFREY BUNKER STOUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8060 WOLF RIVER BLVD, GERMANTOWN, TN 38138-1727
(901) 271-1000
(901) 271-4187
Mailing address
8060 WOLF RIVER BLVD, GERMANTOWN, TN 38138-1727
(901) 271-1000
(901) 271-4187

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MD19835
TN
207RI0011X
Interventional Cardiology Physician
Primary
19835
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3067323
TN
01
3125019
BCBS TN
TN
Enumeration date
08/22/2006
Last updated
02/27/2013
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