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Individual

STUART DEVAUL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5111 CLINTON DR, KOKOMO, IN 46902-7136
(765) 453-8800
(765) 453-8813
Mailing address
5111 CLINTON DR, KOKOMO, IN 46902-7136
(765) 453-8800
(765) 453-8813

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01042975A
IN
207Q00000X
Family Medicine Physician
01042975
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000525514
BCBS
IN
05
200075150E
IN
Enumeration date
10/24/2006
Last updated
07/07/2022
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