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Individual

RODNEY B. STOUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5763
(740) 446-5573
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 441-2133
(740) 446-5573

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
18824
WV
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
35-06-8415
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000007375
ANTHEM BCBS
01
000000185216
UNISON MEDICAID #
OH
01
001714085
MOUNTAIN STATE BCBS
05
0087542000
WV
01
0157744
MOLINA MEDICAID #
OH
05
0157744
OH
01
310917085115
CARESOURCE MEDICAID #
OH
01
460001103
RR MEDICARE
OH
Enumeration date
06/16/2006
Last updated
12/29/2020
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