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NPI Code Detail

MEDICARE: KATIE STOUT DPT, ATC

MEDICARE: KATIE STOUT DPT, ATC
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
12255A2300XAthletic Trainer921OK
2225100000XPhysical Therapist6895OK

General Provider Information

NPI Number : 1154784981
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE STOUT DPT, ATC
Provider Business Mailing Address
First Line : 4800 S 109TH EAST AVE
Second Line :
City : TULSA
State : OK
Zip : 74146-5822
Country : US
Telephone Number : 918-382-1482
Fax Number :
Provider Business Practice Location Address
First Line : 4800 S 109TH EAST AVE
Second Line :
City : TULSA
State : OK
Zip : 74146-5822
Country : US
Telephone Number : 918-392-1482
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2016
Last Update Date : 05/29/2026

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Directions to “ KATIE STOUT DPT, ATC” Practice Location

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