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Mark J Stout, MD
Transplant Surgery Physician in Waukesha, Wisconsin
NPI 1851386551

Mark J Stout is a Transplant Surgery Physician based in Waukesha, WI. Mark J Stout practices in Waukesha, WI and has the professional credentials of MD. The NPI Number for Mark J Stout is 1851386551 and holds a License No. 01069517A (Wisconsin).

The current practice location address for Mark J Stout is 725 American Ave, Waukesha, WI and can be reached out via phone at 608-263-1530.

Location: 725 American Ave, Waukesha, WI, 53188-5031
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1851386551
Provider Name
Mark J Stout
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
725 American Ave, Waukesha, WI, 53188-5031
Phone Number
608-263-1530
Fax Number
Provider Enumeration Date
09/19/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
P01027332 01 IN RAILROAD MEDICARE
000001005823 01 IN ANTHEM PROVIDER NUMBER FOR TIN 35-2030653
036080105 05 IL
01605360 01 IL BCBS PROVIDER ID
201019900 05 IN
780000280 01 IL RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
725 American Ave
City
Waukesha
State
Wisconsin
Zip
53188-5031
Phone Number
608-263-1530
Fax Number
person
Provider Business Mailing Address Details
Address
725 American Ave
City
Waukesha
State
Wisconsin
Zip
53188-5031
Phone Number
608-263-1530
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Transplant Surgery
Speciality
-
Taxonomy
204F00000X
License No.
62383 (Wisconsin)
Definition
Definition to come.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Thoracic Surgery (Cardiothoracic Vascular Surgery)
Speciality
-
Taxonomy
208G00000X
License No.
01069517A (Indiana)
Definition
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
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