Dr Justin Daniel Ellett, MD, PHD | |
2687 Lake Park Drive, N Charleston, SC 29406 | |
(843) 572-1010 | |
(843) 569-1719 |
Full Name | Dr Justin Daniel Ellett |
---|---|
Gender | Male |
Speciality | Urology |
Experience | 13 Years |
Location | 2687 Lake Park Drive, N Charleston, South Carolina |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1275827248 | NPI | - | NPPES |
335989 | Medicaid | SC | |
1275827248 | Other | SC | MEDCOST |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | 33598 (South Carolina) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Trident Medical Center | Charleston, SC | Hospital |
Bon Secours-st Francis Xavier Hospital | Charleston, SC | Hospital |
Roper Hospital | Charleston, SC | Hospital |
Roper St Francis Hospital-berkely Inc | Moncks corner, SC | Hospital |
East Cooper Medical Center | Mount pleasant, SC | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Lowcountry Urology Clinics, Pa | 6406869247 | 16 |
Entity Name | Lowcountry Urology Clinic,pa |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1942242714 PECOS PAC ID: 6406869247 Enrollment ID: O20060724000104 |
Mailing Address | Practice Location Address |
---|---|
Dr Justin Daniel Ellett, MD, PHD 641 Saint Andrews Blvd, Charleston, SC 29407-7165 Ph: (843) 766-4070 | Dr Justin Daniel Ellett, MD, PHD 2687 Lake Park Drive, N Charleston, SC 29406 Ph: (843) 572-1010 |
Benjamin K Mcinnes, MD Urology Medicare: Medicare Enrolled Practice Location: 2687 Lake Park Dr, N Charleston, SC 29406 Phone: 843-572-0097 | |
William H Holl, MD Urology Medicare: Medicare Enrolled Practice Location: 2687 Lake Park Dr, N Charleston, SC 29406 Phone: 843-572-1010 |