Provider Demographics
NPI:1730378951
Name:STOUT, STEVEN C (MD PHD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:C
Last Name:STOUT
Suffix:
Gender:M
Credentials:MD PHD
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Mailing Address - Street 1:P O BOX 370407
Mailing Address - Street 2:PATIENT ACCOUNTS
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-3828
Mailing Address - Country:US
Mailing Address - Phone:404-212-5454
Mailing Address - Fax:404-243-2159
Practice Address - Street 1:3073 PANTHERSVILLE ROAD
Practice Address - Street 2:PATIENT ACCOUNTS
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-3828
Practice Address - Country:US
Practice Address - Phone:404-212-5454
Practice Address - Fax:404-243-2159
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
GA0537282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GABS8572314OtherDEA