Organization
BECKLEY DERMATOLOGY INC.
Active
Organization
BECKLEY DERMATOLOGY INC.
Active
Other names
Dermatology Associates & Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NELSON E. VELAZQUEZ DO (SOLE OWNER)
(304) 252-2673
Entity
Organization
Contact information
Practice address
94 BROOKSHIRE LANE, BECKLEY, WV 25801-6765
(304) 252-2673
(304) 929-2350
Mailing address
148 LINDEN DR, SUITE 101, WINCHESTER, VA 22601-6909
(540) 504-0066
(540) 678-9025
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
MD
207N00000X
Dermatology Physician
Primary
—
WV
207ND0101X
MOHS-Micrographic Surgery Physician
—
WV
207ND0900X
Dermatopathology Physician
—
WV
207NS0135X
Procedural Dermatology Physician
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720089279
—
WV
05
—
258407700
—
MD
Enumeration date
08/09/2005
Last updated
02/15/2017
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