Individual
DR. TIMOTHY MARK STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
320 CHESHIRE DR, KNOXVILLE, TN 37919-5813
(800) 500-4667
(833) 448-2982
Mailing address
1275 DICK LONAS RD, KNOXVILLE, TN 37909-1382
(865) 584-4747
(865) 381-1509
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
0429147
KS
207W00000X
Ophthalmology Physician
MD108395
MO
207W00000X
Ophthalmology Physician
MD68554
TN
207WX0107X
Retina Specialist (Ophthalmology) Physician
04-29147
KS
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
68554
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180041348
RAILROAD MEDICARE
—
01
—
180041349
RAILROAD MEDICARE
—
Enumeration date
08/23/2005
Last updated
08/02/2024
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