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Individual

RICHARD R STOUT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
70 MASON ST, GENEVA, NY 14456-1104
(315) 789-3937
(315) 789-2616
Mailing address
70 MASON ST, GENEVA, NY 14456-1104
(315) 789-3937
(315) 789-2616

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
225735
NY
332H00000X
Eyewear Supplier
225735
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
141751CR
PREFERRED CARE OPTION
01
201178047
GROUP HEALTH INCORPORATED
01
4086529
AETNA
01
7700447
MVP SELECT CARE
01
7702618
DOCTORS HEALTH PLAN
01
82636
FIRST HEALTH
01
P00141516
RAILROAD MEDICARE
01
P010225735
EXCELLUS BCBS
Enumeration date
03/22/2006
Last updated
01/23/2014
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