Stout, Keith B

Stout, Keith B is an individual health care provider with primary practice located at 3480 College St , Beaumont TX 77701-4612. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Stout, Keith B can be contacted via phone (409) 813-1677.

Contact Information

Primary practice address
3480 College St Beaumont TX 77701-4612
Phone: (409) 813-1677
Fax: (409) 730-1399
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X E9428 Texas
Allopathic & Osteopathic Physicians / General Practice 208D00000X E9428 Texas

Profile Details

NPI number 1053314393
LBN Legal business name Stout, Keith B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2005
Last updated Jan 19th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053314393 NPPES
Texas MEDICAID 137850712

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