Individual
MR. RUSSELL STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3601 S 6TH AVE, TUCSON, AZ 85723-0001
(520) 629-1781
Mailing address
4575 E WICKERSHAM RD, HEREFORD, AZ 85615-8651
(520) 226-5031
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN129045
AZ
Other
Enumeration date
02/28/2011
Last updated
02/28/2011
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