Healthcare Provider Details

I. General information

NPI: 1609064021
Provider Name (Legal Business Name): RICHARD H. STOUT, MD PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2007
Last Update Date: 03/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2957 US HWY 641 NORTH
MURRAY KY
42071-7840
US

IV. Provider business mailing address

2957 US HWY 641 NORTH
MURRAY KY
42071-7840
US

V. Phone/Fax

Practice location:
  • Phone: 270-753-7451
  • Fax: 270-759-1215
Mailing address:
  • Phone: 270-753-7451
  • Fax: 270-759-1215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number13975
License Number StateKY

VIII. Authorized Official

Name: DR. RICHARD H STOUT
Title or Position: PRESIDENT
Credential: MD
Phone: 270-753-7451