Timothy Ray Stout, is a
Student In An Organized Health Care Education/training Program based in Tulsa, Oklahoma. Timothy Ray Stout is licensed to practice in * (Not Available) (license number ) and his current practice location is
9119 S 90th East Ave, Tulsa, Oklahoma. He can be reached at his office (for appointments etc.) via phone at
(918) 693-0161.
NPI number for Timothy Ray Stout is 1174307250 and his current mailing address is 9119 S 90th East Ave, Tulsa, Oklahoma. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1174307250.
Provider's Profile
| Full Name | Timothy Ray Stout |
|---|
| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 9119 S 90th East Ave, Tulsa, Oklahoma |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1174307250
- Provider Enumeration Date: 08/21/2023
- Last Update Date: 08/21/2023
Medical Identifiers
Medical identifiers for Timothy Ray Stout such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1174307250 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Timothy Ray Stout is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Timothy Ray Stout,
9119 S 90th East Ave,
Tulsa, OK 74133-5607
Ph: (918) 693-0161 | Timothy Ray Stout,
9119 S 90th East Ave,
Tulsa, OK 74133-5607
Ph: (918) 693-0161 |
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