Mark Patrick Stout, PAC Valid NPI
Individual provider · Physician Assistant · Edmond, OK
- NPI
- 1033456728
- Type
- Individual (Type 1)
- Primary specialty
- Physician Assistant
- Specialty group
- Physician Assistants & Advanced Practice Nursing Providers
- Taxonomy code
- 363A00000X
- License number
- 2208 (OK)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2013-01-15
- Last updated
- 2018-03-30
Practice location
18503 N Portland Ave
Edmond, OK 73012-9149
(405) 531-4273