| Evan Ray Stout, MD | |
|
2301 S Ingram Ave, Sedalia, MO 65301-8121 | |
| (660) 826-5890 | |
| (660) 826-4802 |
| Full Name | Evan Ray Stout |
|---|---|
| Gender | Male |
| Speciality | Sports Medicine |
| Experience | 14 Years |
| Location | 2301 S Ingram Ave, Sedalia, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669762811 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207XX0005X | Orthopaedic Surgery - Sports Medicine | 2016023793 (Missouri) | Secondary |
| 207X00000X | Orthopaedic Surgery | 2016023793 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Bothwell Regional Health Center | Sedalia, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Legacy Healthcare Services Inc | 2163339722 | 3474 |
| Bothwell Regional Health Center | 6103714126 | 106 |
| Entity Name | Bothwell Regional Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235102690 PECOS PAC ID: 6103714126 Enrollment ID: O20040310000246 |
| Mailing Address | Practice Location Address |
|---|---|
| Evan Ray Stout, MD Po Box 843966, Kansas City, MO 64184-3966 Ph: (573) 882-3300 | Evan Ray Stout, MD 2301 S Ingram Ave, Sedalia, MO 65301-8121 Ph: (660) 826-5890 |
Douglas W Kiburz, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 2301 S Ingram Ave, Sedalia, MO 65301 Phone: 660-826-5890 | |
Dr. Brian K Ellefsen, DO Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 2100 W Main St, Sedalia, MO 65301 Phone: 660-826-5750 Fax: 660-829-5750 | |
Ryan K Edwards, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 2301 S Ingram Ave, Sedalia, MO 65301 Phone: 660-827-0505 Fax: 660-826-4802 |