Individual
DEREK RUSSELL STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
810 FAIRGROVE CHURCH RD, HICKORY, NC 28602-9617
(855) 968-8233
(866) 502-1008
Mailing address
PO BOX 488, CONOVER, NC 28613-0488
(855) 968-8233
(866) 502-1008
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2022-01044
NC
207L00000X
Anesthesiology Physician
21104
NH
Other
Enumeration date
04/20/2016
Last updated
05/22/2023
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