Individual
DR. ERIC CAMERON STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 STARLING ST STE 305, BRUNSWICK, GA 31520-4265
(912) 554-0542
(912) 554-0475
Mailing address
2500 STARLING ST STE 305, BRUNSWICK, GA 31520-4265
(912) 554-0542
(912) 554-0475
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
056629
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-3106721
TAX ID
GA
05
—
660215053A
—
GA
Enumeration date
08/23/2006
Last updated
02/23/2016
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