Full Name | |
---|---|
Speciality | Internal Medicine |
Location | 50 Terrace Dr, Ridgeland, South Carolina |
Authorized Official Name and Position | Thomas J Duncan (CEO) |
Authorized Official Contact | 8505584665 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
1514 Jefferson Hwy New Orleans LA 70121-2429 Ph: () - | 50 Terrace Dr Ridgeland SC 29936 Ph: (843) 547-4765 |
NPI Number | 1497455232 |
---|---|
Provider Enumeration Date | 03/09/2023 |
Last Update Date | 09/12/2023 |
Medicare PECOS PAC ID | 5294181939 |
---|---|
Medicare Enrollment ID | O20231031003883 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497455232 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Gail L Rearden |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1568582906 PECOS PAC ID: 7618060005 Enrollment ID: I20070830000201 |
Provider Name | Peggy Bourguillon |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1073922753 PECOS PAC ID: 3971807157 Enrollment ID: I20180523002308 |
Provider Name | William R Gailmard |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1124022884 PECOS PAC ID: 8325077084 Enrollment ID: I20231113001979 |
Provider Name | James Delroy Mayers |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1750906988 PECOS PAC ID: 5799100194 Enrollment ID: I20231220003198 |
Provider Name | Rachael Kermis |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1265886303 PECOS PAC ID: 3375838444 Enrollment ID: I20240715001173 |
Bennett Medical Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10876a N Jacob Smart Blvd, Ridgeland, SC 29936 Phone: 843-694-7728 | |
Altea Medical South Carolina Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1516 Grays Hwy, Ridgeland, SC 29936 Phone: 843-726-5581 |