Individual provider · Type 1 NPI

Justin Tyler Stout, DO

Student in an Organized Health Care Education/Training Program · Philadelphia, PA

NPI number 1871389015 Active

Practice location

1020 Sansom St Ste 1651
Philadelphia, PA 19107-5002

Call (215) 955-9837 Map

Fax (215) 955-9870

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1871389015

Justin Tyler Stout, DO's National Provider Identifier is 1871389015, issued on Apr 15, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Philadelphia, PA. The record was last updated on May 30, 2025.