Provider Demographics
NPI:1336331214
Name:DEHART, DILLARD LOVELL (DO)
Entity Type:Individual
Prefix:
First Name:DILLARD
Middle Name:LOVELL
Last Name:DEHART
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 SWIFTWATER RD
Mailing Address - Street 2:
Mailing Address - City:WOODSVILLE
Mailing Address - State:NH
Mailing Address - Zip Code:03785-1446
Mailing Address - Country:US
Mailing Address - Phone:603-747-9000
Mailing Address - Fax:603-764-7331
Practice Address - Street 1:90 SWIFTWATER RD
Practice Address - Street 2:
Practice Address - City:WOODSVILLE
Practice Address - State:NH
Practice Address - Zip Code:03785-1446
Practice Address - Country:US
Practice Address - Phone:603-747-9000
Practice Address - Fax:603-747-3310
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12429207R00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice