Dr Richard K Ellis, MD | |
148 Sauls St, Lake City, SC 29560-2631 | |
(843) 374-3621 | |
(843) 374-3624 |
Full Name | Dr Richard K Ellis |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 148 Sauls St, Lake City, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1245336932 | NPI | - | NPPES |
211826 | Medicaid | SC | |
P01055600 | Other | SC | RR PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 21182 (South Carolina) | Primary |
Entity Name | Carolina Family Care Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1184655722 PECOS PAC ID: 4587557731 Enrollment ID: O20040203000627 |
Entity Name | Carolinas Medical Alliance Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023238490 PECOS PAC ID: 9739096769 Enrollment ID: O20050201000341 |
Mailing Address | Practice Location Address |
---|---|
Dr Richard K Ellis, MD Po Box 118008, Charleston, SC 29423-8008 Ph: (843) 374-3621 | Dr Richard K Ellis, MD 148 Sauls St, Lake City, SC 29560-2631 Ph: (843) 374-3621 |
Dr. Benjamin Wade Lamb, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 148 Sauls St, Lake City, SC 29560 Phone: 843-374-3621 Fax: 843-374-3624 | |
Dr. Ernest M Atkinson, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 148 Sauls St, Lake City, SC 29560 Phone: 843-374-3621 Fax: 843-374-3624 | |
Dr. James J Thomy, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 258 N Ron Mcnair Blvd, Lake City, SC 29560 Phone: 843-374-2036 Fax: 843-374-5111 | |
Dr. David W Moon, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 276 N Ron Mcnair Blvd, Lake City, SC 29560 Phone: 843-394-5471 Fax: 843-394-5459 | |
Dr. Albert D Mims, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 148 Sauls St, Lake City, SC 29560 Phone: 843-374-3621 Fax: 843-374-3624 | |
Dr. Daniel E Decamps, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 276 N Ron Mcnair Blvd, Lake City, SC 29560 Phone: 843-394-5471 Fax: 843-394-5459 |