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General NPI Number Information
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NPI Number | 1720920176
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Entity Type | Individual
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Provider Name | BRYCE ANDREW STOUT PA-C
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Gender | Male
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Dates
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Enumeration Date | 04/06/2026
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Last Update Date | 04/06/2026
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Provider Practice Location Address
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Address Line | 807 N MAIN ST
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City | TRAVELERS REST
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State | SC
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Zip | 29690-1551
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Country | US
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Telephone | 864-455-9790
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Fax |
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Provider Business Mailing Address
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Address Line | 1437 JARMEL WAY
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City | GREER
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State | SC
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Zip | 29650-1760
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 6246
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License Number State | SC
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