DEREK STOUT

MATTOON, IL
NPI1548376213
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: IL  036-107399)
Additional Taxonomies207R00000X Internal Medicine
(Licence: IL  036-107399)
Enumeration Date2006-08-22
Last Update Date2019-01-08
Business Address
DEREK STOUT D.O.
1000 HEALTH CENTER DR
MATTOON, IL 61938-9261
Phone number: 217-258-2551
Mailing Address
DEREK STOUT D.O.
1005 HEALTH CENTER DR STE 201
MATTOON, IL 61938-4693
Phone number: 217-238-6055