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General NPI Number Information
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NPI Number | 1730378951
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Entity Type | Individual
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Provider Name | STEVEN C STOUT MD PHD
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Gender | Male
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Dates
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Enumeration Date | 10/24/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 3073 PANTHERSVILLE ROAD PATIENT ACCOUNTS
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City | DECATUR
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State | GA
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Zip | 30034-3828
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Country | US
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Telephone | 404-212-5454
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Fax | 404-243-2159
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Provider Business Mailing Address
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Address Line | P O BOX 370407 PATIENT ACCOUNTS
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City | DECATUR
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State | GA
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Zip | 30034-3828
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Country | US
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Telephone | 404-212-5454
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Fax | 404-243-2159
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 053728
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License Number State | GA
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