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General NPI Number Information
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NPI Number | 1194936799
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Entity Type | Individual
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Provider Name | WILLIAM KELLY DEHART DO
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Gender | Male
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 06/24/2024
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Provider Practice Location Address
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Address Line | 510 INDEPENDENCE PKWY STE 600
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City | CHESAPEAKE
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State | VA
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Zip | 23320-5220
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Country | US
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Telephone | 757-622-6315
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Fax | 757-622-7022
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Provider Business Mailing Address
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Address Line | 6160 KEMPSVILLE CIR SUITE 200 A
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City | NORFOLK
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State | VA
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Zip | 23502-3933
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Country | US
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Telephone | 757-622-6315
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Fax | 757-562-2702
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 0102202224
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License Number State | VA
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