Logan Carlyle, is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Columbia, South Carolina. His current practice location is
2 Medical Park Rd, Columbia, South Carolina. You can reach out to his office (for appointments etc.) via phone at
(803) 434-6956.
Logan Carlyle is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1932804374.
Physician's Profile
Full Name | Logan Carlyle |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 2 Medical Park Rd, Columbia, South Carolina |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1932804374
- Provider Enumeration Date: 04/04/2023
- Last Update Date: 07/11/2023
Medicare PECOS Information:
- PECOS PAC ID: 5294197166
- Enrollment ID: I20230810000352
Medical Identifiers
Medical identifiers for Logan Carlyle such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1932804374 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | LL89733 (South Carolina) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Logan Carlyle is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Logan Carlyle, 2 Medical Park Rd, Columbia, SC 29203-6808 Ph: () - | Logan Carlyle, 2 Medical Park Rd, Columbia, SC 29203-6808 Ph: (803) 434-6956 |
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