Individual
DR. RANDALL C STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3600 CAPITAL AVE SW, STE 203, BATTLE CREEK, MI 49015-9393
(269) 979-6383
(269) 979-6381
Mailing address
3600 CAPITAL AVE SW, STE 203, BATTLE CREEK, MI 49015-9393
(269) 979-6383
(269) 979-6381
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
RS045322
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0831634
PHP
MI
05
—
3158180
—
MI
05
—
383224959100
—
MI
01
—
RS048655
LICENSE
MI
Enumeration date
12/27/2006
Last updated
07/09/2007
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