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Organization

RICHARD R STOUT MD PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD R STOUT MD (PRESIDENT)
(315) 789-3937
Entity
Organization

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
05
02368770
NY
01
141751CR
PREFERRED ONE
01
4086529
AETNA
01
7700447
MVP SELECT CARE
01
7702618
DOCTORS HEALTH PLAN
01
82636
FIRST HEALTH
01
P00141516
RAILROAD MEDICARE
01
P0100225735
HEALTHY NY
Enumeration date
02/05/2007
Last updated
04/20/2008
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