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BECKLEY DERMATOLOGY INC. NPI 1720089279


NPI Information

NPI: 1720089279
Provider Name: BECKLEY DERMATOLOGY INC.

Doing Business As: DERMATOLOGY ASSOCIATES & SURGERY CENTER

Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 51D2003888

Address:
94 BROOKSHIRE LANE
BECKLEY, WV
ZIP 25801
Phone: (304) 252-2673
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BECKLEY DERMATOLOGY INC. is a dermatology in Beckley, WV. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. BECKLEY DERMATOLOGY INC. NPI is 1720089279. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Dermatology Associates & Surgery Center.

The provider's business location address is:

94 BROOKSHIRE LANE
BECKLEY, WV
ZIP 25801-765
Phone: (304) 252-2673
Fax: (304) 929-2350

The provider's authorized official is Nelson E. Velazquez .
The authorized official title is Sole Owner and has the following contact phone number (304) 252-2673.

The CLIA number assigned to this NPI record is 51D2003888 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/9/2005 and was last updated on 2/15/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207N00000XDermatologyWEST VIRGINIAYes
2207N00000XDermatologyMARYLANDNo
3207ND0101XDermatologyMOHS-Micrographic SurgeryWEST VIRGINIANo
4207ND0900XDermatologyDermatopathologyWEST VIRGINIANo
5207NS0135XDermatologyProcedural DermatologyWEST VIRGINIANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1553156MEDICARE PINMARYLAND
29314931MEDICARE PINWEST VIRGINIA
3258407700MEDICAIDMARYLAND
41720089279MEDICAIDWEST VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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