DR. DWIGHT CLESSON KELLICUT MD NPI 1871518662

NPI Information

NPI: 1871518662
Provider Name: DR. DWIGHT CLESSON KELLICUT, MD
Classification: Surgery - 2086S0129X
Entity Type: Individual

Specialization: Vascular Surgery

Address:
1 JARRETT WHITE RD
TRIPLER ARMY MEDICAL CENTER, HI
ZIP 96859
Phone: (808) 433-6777
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DR. Dwight Clesson Kellicut, MD is a vascular surgery surgery in Tripler Army Medical Center, HI. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. DR. Dwight Clesson Kellicut, MD NPI is 1871518662. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1 JARRETT WHITE RD
TRIPLER ARMY MEDICAL CENTER, HI
ZIP 96859-001
Phone: (808) 433-6777

The enumeration date for this NPI number is 7/13/2006 and was last updated on 7/28/2023.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0129X	Surgery	Vascular Surgery	01053701A	INDIANA	Yes

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

NPI Synchronization or Removal

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