Individual
EMMA IOVANE STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
115 E. RIVERWALK, SUITE 200, PUEBLO, CO 81003-2246
(719) 543-8346
Mailing address
115 E. RIVERWALK, SUITE 200, PUEBLO, CO 81003-2246
(719) 543-8346
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
51770
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
270883714
RMVI
CO
Enumeration date
07/08/2009
Last updated
02/28/2014
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