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General NPI Number Information
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NPI Number | 1487148268
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Entity Type | Individual
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Provider Name | KRISTOPHER DOLEHANTY PA-C
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Gender | Male
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Dates
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Enumeration Date | 06/15/2018
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 2782 N COBB PKWY
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City | KENNESAW
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State | GA
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Zip | 30152-3472
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Country | US
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Telephone | 770-420-1092
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Fax |
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Provider Business Mailing Address
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Address Line | 2782 N COBB PKWY
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City | KENNESAW
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State | GA
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Zip | 30152-3472
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Country | US
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Telephone | 770-420-1092
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10809
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License Number State | GA
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