Beckley Dermatology Inc.
Organization Active NPI Dermatology Physician · Princeton, WV
NPI 1578035606 · NPPES record last updated Dec 31, 2018
Key facts
- NPI
- 1578035606
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dermatology Physician 207N00000X
- Legal business name
- BECKLEY DERMATOLOGY INC.
- Practice address
- 508 New Hope Rd Ste 102
Princeton, WV 24740-2265 - Phone
- (304) 487-9100
- Fax
- (304) 487-9311
- NPI assigned
- Dec 31, 2018
- Organization subpart
- Yes
- Parent organization (as reported)
- BECKLEY DERMATOLOGY INC
Authorized official
- Name
- Nelson E. Velazquez, DO
- Title
- Owner
- Phone
- (304) 252-2673
Corporate family (same tax ID) 6
Practitioners 1
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 51D2013929 | Dermatology Associates & Surgery Center | Compliance | Mar 8, 2027 |
National Provider Directory
- Tax ID family
- Beckley Dermatology Inc
- Part of
- Beckley Dermatology Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | Yes | ||
| MOHS-Micrographic Surgery Physician |
207ND0101X | |||
| Dermatopathology Physician |
207ND0900X |
Addresses
Primary practice location
508 New Hope Rd Ste 102
Princeton, WV 24740-2265
Mailing address
136 Linden Dr Ste 104
Winchester, VA 22601-6900
Phone (540) 678-3588
Other names
- Dermatology Associates & Surgery Center
Other providers in Princeton, WV
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- Beckley Vamc
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- Brittany Belcher
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All providers in Princeton, WV · Dermatology Physician in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.