| Dr Lisa Carlson, MD | |
|
1213 Remount Rd Ste E, North Charleston, SC 29406-3433 | |
| (864) 319-3782 | |
| Not Available |
| Full Name | Dr Lisa Carlson |
|---|---|
| Gender | Female |
| Speciality | Internal Medicine |
| Location | 1213 Remount Rd Ste E, North Charleston, 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 |
|---|---|---|---|
| 1598772212 | NPI | - | NPPES |
| 361852 | Medicaid | SC | |
| P01352894 | Other | SC | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 36185 (South Carolina) | Primary |
| 207R00000X | Internal Medicine | 56271 (Georgia) | Secondary |
| Entity Name | Conviva Medical Center Management of Texas, P.A. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710341144 PECOS PAC ID: 8729302278 Enrollment ID: O20160808001129 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Lisa Carlson, MD Po Box 2168, Spartanburg, SC 29304-2168 Ph: (864) 560-4123 | Dr Lisa Carlson, MD 1213 Remount Rd Ste E, North Charleston, SC 29406-3433 Ph: (864) 319-3782 |
David Anthony Florez, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2671 Elms Plantation Blvd, North Charleston, SC 29406 Phone: 843-797-6800 Fax: 843-797-6825 |
Dr. Charles Dudley Graham, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 2910 Tricom St, North Charleston, SC 29406 Phone: 843-572-9211 Fax: 843-572-0457 |
Jenny Mccallister Riley, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 9313 Medical Plaza Dr Ste 103, North Charleston, SC 29406 Phone: 843-790-8280 Fax: 843-974-8500 |
Dr. Daniel Alden Williams, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 8992 University Blvd Fl 3, North Charleston, SC 29406 Phone: 843-792-1414 |
Dr. Ashley Abide Jeter, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2910 Tricom St, North Charleston, SC 29406 Phone: 843-572-9211 Fax: 843-572-0457 |
Dr. Darren S Sidney, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 9221 University Blvd, Suite 102, North Charleston, SC 29406 Phone: 843-576-0700 Fax: 843-576-0701 |
Kevin Michael Smith, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 9330 Medical Plaza Dr, North Charleston, SC 29406 Phone: 843-847-3225 |