Individual
KEVAN STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2790 CLAY EDWARDS DR STE 1250, NORTH KANSAS CITY, MO 64116-3260
(816) 421-3700
(816) 421-3700
Mailing address
1684 E TIARA PINES CIR, DERBY, KS 67037-3926
(316) 259-4791
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
09/18/2015
Last updated
03/17/2018
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