| Ashley Lucas Clark, MD | |
|
727 Se Main St, Suite 100, Simpsonville, SC 29681-3247 | |
| (864) 454-6520 | |
| (864) 454-6525 |
| Full Name | Ashley Lucas Clark |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 727 Se Main St, Simpsonville, 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 |
|---|---|---|---|
| 1730115676 | NPI | - | NPPES |
| 57-1004971003 | Other | SC | BCBS OF SC |
| 7742353 | Other | SC | AETNA |
| 210435 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 21043 (South Carolina) | Primary |
| Entity Name | Prisma Health University Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295763217 PECOS PAC ID: 8325950983 Enrollment ID: O20031103000238 |
| Mailing Address | Practice Location Address |
|---|---|
| Ashley Lucas Clark, MD 1 Independence Pt, Suite 212, Greenville, SC 29615-4545 Ph: (864) 797-6044 | Ashley Lucas Clark, MD 727 Se Main St, Suite 100, Simpsonville, SC 29681-3247 Ph: (864) 454-6520 |
Lindsey Brianne Mcamis Gouge, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 312 Harrison Bridge Rd, Simpsonville, SC 29680 Phone: 864-272-0388 Fax: 864-213-9237 | |
Dr. Ashleigh Brooke Gardner, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 211 Batesville Rd, Simpsonville, SC 29681 Phone: 864-272-0388 Fax: 864-213-9237 | |
Dr. Emily Elizabeth Phillips, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 211 Batesville Rd, Simpsonville, SC 29681 Phone: 864-272-0388 | |
Heather Alexis Moreira, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 727 Se Main St, Suite 300, Simpsonville, SC 29681 Phone: 864-454-6440 Fax: 864-454-6445 | |
Dr. Laura Anne Johnson, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 727 Se Main St Ste 320, Simpsonville, SC 29681 Phone: 864-454-6440 | |
Daniel Hughes, Pediatrics Medicare: Medicare Enrolled Practice Location: 2 Hatcher Creek St., Simpsonville, SC 29680 Phone: 864-272-0388 | |
Todd A Roemmich, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 312 Harrison Bridge Rd, Simpsonville, SC 29680 Phone: 864-272-0388 Fax: 864-213-9237 |