MEDICARE: DR. ADAM L STOUT DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH10219	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417246836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM L STOUT DC

Provider Business Mailing Address
First Line	:	6718 N NEBRASKA AVE
Second Line	:	SUITE 1
City	:	TAMPA
State	:	FL
Zip	:	33604
Country	:	US
Telephone Number	:	813-822-6804
Fax Number	:	813-522-6722

Provider Business Practice Location Address
First Line	:	6718 N NEBRASKA AVE
Second Line	:	SUITE 1
City	:	TAMPA
State	:	FL
Zip	:	33604
Country	:	US
Telephone Number	:	813-822-6804
Fax Number	:	813-522-6722

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2011
Last Update Date	:	12/17/2021

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Directions to “ DR. ADAM L STOUT DC” Practice Location

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