Provider Demographics
NPI:1922137843
Name:STOUTLAND, HARRY OLIVER (M D)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:OLIVER
Last Name:STOUTLAND
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 W SUMMIT DR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47712-9078
Mailing Address - Country:US
Mailing Address - Phone:812-985-0144
Mailing Address - Fax:
Practice Address - Street 1:1800 W SUMMIT DR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-9078
Practice Address - Country:US
Practice Address - Phone:812-985-0144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01036544207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine