Individual
DAVID C STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4 PEBBLE CRK, HATTIESBURG, MS 39402-8370
(601) 261-9323
Mailing address
4 PEBBLE CRK, HATTIESBURG, MS 39402-8370
(601) 261-9323
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
14328
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115125
—
MS
01
—
130011551
RAILROAD MEDICARE
MS
01
—
640507572AV
AMERICAN ADMIN GROUP
MS
Enumeration date
08/29/2006
Last updated
10/21/2021
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