Individual
DR. DWIGHT CLESSON KELLICUT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER, HI 96859-5001
(808) 433-6777
Mailing address
4725 BOUGAINVILLE DR # 115, HONOLULU, HI 96818-3179
(864) 455-7000
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
01053701A
IN
Other
Enumeration date
07/13/2006
Last updated
07/28/2023
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