| Lifestyle Neurology, Llc | |
|
420 The Parkway Suite N Greer SC 29650-5205 | |
| (864) 655-4005 | |
| Not Available |
| Full Name | Lifestyle Neurology, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 420 The Parkway, Greer, South Carolina |
| Authorized Official Name and Position | Mary Hughes (ADMINISTRATOR) |
| Authorized Official Contact | 8642380471 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifestyle Neurology, Llc 420 The Parkway Suite N Greer SC 29650-5205 Ph: (864) 655-4005 | Lifestyle Neurology, Llc 420 The Parkway Suite N Greer SC 29650-5205 Ph: (864) 655-4005 |
| NPI Number | 1902281173 |
|---|---|
| Provider Enumeration Date | 07/29/2015 |
| Last Update Date | 10/05/2023 |
| Certification Date | 10/05/2023 |
| Medicare PECOS PAC ID | 6800106469 |
|---|---|
| Medicare Enrollment ID | O20151111000001 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902281173 | NPI | - | NPPES |
| 1538406491 | Other | NPI | |
| 1679057772 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 30585 (South Carolina) | Primary |
| Provider Name | Adele Lanford Freeman |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1609834746 PECOS PAC ID: 2567427131 Enrollment ID: I20041123000272 |
| Provider Name | Mary Denise Hughes |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275643561 PECOS PAC ID: 0244394393 Enrollment ID: I20151112002476 |
| Provider Name | Megan Roben Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679057772 PECOS PAC ID: 3173863339 Enrollment ID: I20190326000658 |
| Provider Name | Porshia Alice Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265001531 PECOS PAC ID: 2365846540 Enrollment ID: I20210810002914 |
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