Kelly Dallas, PA-C
Physician Assistant in Medford, New Jersey
1497091193- Practice location
- 131 Route 70 Ste 100A, Medford, NJ 08055-9501
- Phone
- 609-267-9400
- Fax
- 609-451-5518
- Last updated
- February 26, 2026
Kelly Dallas is a Physician Assistant based in Medford, NJ. Kelly Dallas practices in Medford, NJ and has the professional credentials of PA-C. The NPI Number for Kelly Dallas is 1497091193 and holds a License No. 25MP00300900 (NJ). The current practice location address for Kelly Dallas is 131 Route 70 Ste 100A, Medford, NJ 08055-9501 and can be reached out via phone at 609-267-9400 and via fax at 609-451-5518.
Provider Profile Details
- NPI Number
- 1497091193
- Provider Name
- Kelly Dallas
- Credential
- PA-C
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 131 Route 70 Ste 100A, Medford, NJ 08055-9501
- Phone Number
- 609-267-9400
- Fax Number
- 609-451-5518
- Primary Taxonomy
- Physician Assistant · 363A00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- December 27, 2012
- Last Update Date
- February 26, 2026
- Certification Date
- February 26, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 131 Route 70 Ste 100A
Medford, NJ 08055-9501 - City
- Medford
- State
- New Jersey
- Zip
- 08055-9501
- Phone Number
- 609-267-9400
- Fax Number
- 609-451-5518
Provider Business Mailing Address Details
- Address
- 301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197 - City
- Marlton
- State
- NJ
- Zip
- 08053-4197
License Information
- License Number
- 25MP00300900
- License State
- NJ
- Taxonomy
- Physician Assistant · 363A00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Kelly Dallas, PA-C?
The NPI number of Kelly Dallas, PA-C is 1497091193. It was assigned on December 27, 2012 and is currently active in the NPPES registry.
What is the specialty of Kelly Dallas, PA-C?
Kelly Dallas, PA-C is registered under the primary taxonomy Physician Assistant (code 363A00000X), licensed in NJ under license number 25MP00300900.
Where does Kelly Dallas, PA-C practice?
The practice location is 131 Route 70 Ste 100A, Medford, NJ 08055-9501. The office can be reached at 609-267-9400 (phone) or 609-451-5518 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1497091193 directly on the NPPES registry website.