MEDICARE: MONICA A STOUT M.D.

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
1	207QG0300X	Geriatric Medicine (Family Medicine) Physician	66649-20	WI
2	207QG0300X	Geriatric Medicine (Family Medicine) Physician	62020	TN

General Provider Information

NPI Number	:	1922493576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA A STOUT M.D.

Provider Business Mailing Address
First Line	:	8911 N CAPITAL OF TEXAS HWY STE 1110
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-7203
Country	:	US
Telephone Number	:	877-279-5960
Fax Number	:

Provider Business Practice Location Address
First Line	:	1366 E SUMNER ST # 1002
Second Line	:
City	:	HARTFORD
State	:	WI
Zip	:	53027-1614
Country	:	US
Telephone Number	:	877-279-5960
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2015
Last Update Date	:	12/31/2025

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