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General NPI Number Information
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NPI Number | 1992042899
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Entity Type | Individual
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Provider Name | RONALD WAYNE STOUT MD
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Gender | Male
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Dates
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Enumeration Date | 01/11/2013
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Last Update Date | 02/03/2016
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Provider Practice Location Address
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Address Line | 8700 S MASON MONTGOMERY RD
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City | MASON
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State | OH
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Zip | 45040-9760
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Country | US
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Telephone | 513-622-2788
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Fax |
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Provider Business Mailing Address
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Address Line | 8700 S MASON MONTGOMERY RD
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City | MASON
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State | OH
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Zip | 45040-9760
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Country | US
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Telephone | 513-622-2788
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G63595
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2083P0500X
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Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
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License Number | 35071846
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 2083P0500X
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Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
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License Number | ME113863
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 2083P0500X
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Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
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License Number | G63595
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License Number State | CA
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