Stout, Kerrick Louis

Stout, Kerrick Louis is an individual health care provider with primary practice located at 6000 Kanakanak Rd , Dillingham AK 99576. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Stout, Kerrick Louis can be contacted via phone (907) 842-5201.

Contact Information

Primary practice address
6000 Kanakanak Rd Dillingham AK 99576
Phone: (907) 842-5201
Fax: (907) 842-9250
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4902 Alaska
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 34237 Kentucky
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 34237 Kentucky

Profile Details

NPI number 1710961172
LBN Legal business name Stout, Kerrick Louis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated Mar 11th, 2015 - 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 1710961172 NPPES
Alaska MEDICAID MD6411

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