Griffin Stout, MD | |
6055 Tain Dr Ste 103, Dublin, OH 43017-8449 | |
(614) 668-5975 | |
Not Available |
Full Name | Griffin Stout |
---|---|
Gender | Female |
Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
Location | 6055 Tain Dr Ste 103, Dublin, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1487825154 | NPI | - | NPPES |
0065795 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 35.099210 (Ohio) | Primary |
Entity Name | Pediatric Academic Association, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063419943 PECOS PAC ID: 2961306774 Enrollment ID: O20031124000198 |
Mailing Address | Practice Location Address |
---|---|
Griffin Stout, MD 6055 Tain Dr Ste 103, Dublin, OH 43017-8449 Ph: (614) 668-5975 | Griffin Stout, MD 6055 Tain Dr Ste 103, Dublin, OH 43017-8449 Ph: (614) 668-5975 |
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