Individual
BILLY HERMAN STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1215 NW 25TH ST, OKLAHOMA CITY, OK 73106-5629
(405) 525-2525
(405) 524-3549
Mailing address
3017 PINE RIDGE RD, OKLAHOMA CITY, OK 73120-5930
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8295
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1108295
—
OK
Enumeration date
10/13/2006
Last updated
09/13/2011
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