Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Timothy Ray Stout

Individual provider Physician Assistant · NPI 1174307250

Timothy Ray Stout is a Physician Assistant in Tulsa, Oklahoma. Graduated from Oklahoma State University College of Osteopathic Medicine in 2025, 1 year ago. Practices with Warren Clinic Inc, a 772-clinician group and accepts Medicare assignment.

Years since qualifying
1
Trained at
Oklahoma State University College of Osteopathic Medicine
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

9119 S 90th East Ave
Tulsa, OK 74133-5607
Phone: (918) 693-0161
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1174307250
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 21, 2023
Last updated in NPPESAugust 21, 2023
Certification dateAugust 21, 2023
Mailing address9119 S 90th East Ave, Tulsa, OK 74133-5607

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 2025 (1 years in practice)
Group practice Warren Clinic Inc — 772 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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