Individual
DARREL L. STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1575 N SANTA FE AVE, EDMOND, OK 73003-3638
(405) 285-0660
(405) 285-0659
Mailing address
1575 N SANTA FE AVE, EDMOND, OK 73003-3638
(405) 285-0660
(405) 285-0659
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14799
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100258660A
—
OK
01
—
14799
LICENSE
OK
Enumeration date
07/21/2006
Last updated
01/23/2019
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