Mr Terry Lee Clark Jr, PA-C - Physician Assistant in Charleston, SC

Mr Terry Lee Clark Jr, PA-C is a Physician Assistant - Surgical based in Charleston, South Carolina. Mr Terry Lee Clark Jr is licensed to practice in South Carolina (license number A475) and his current practice location is 109 Bee St, Charleston, South Carolina. He can be reached at his office (for appointments etc.) via phone at (843) 789-7330.

NPI number for Mr Terry Lee Clark Jr is 1053310516 and his current mailing address is 5711 Captain Kidd Rd, Hollywood, South Carolina. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1053310516.

Contact Information

Mr Terry Lee Clark Jr, PA-C
109 Bee St,
Charleston, SC 29401-5703
(843) 789-7330
Not Available

Map and Direction




Provider's Profile

Full NameMr Terry Lee Clark Jr
GenderMale
SpecialityPhysician Assistant - Surgical
Location109 Bee St, Charleston, South Carolina
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1053310516
  • Provider Enumeration Date: 07/18/2005
  • Last Update Date: 02/04/2008

Medical Identifiers

Medical identifiers for Mr Terry Lee Clark Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053310516NPI-NPPES
QM0402MedicaidSC

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AS0400XPhysician Assistant - Surgical A475 (South Carolina)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. Mr Terry Lee Clark Jr is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Terry Lee Clark Jr, PA-C
5711 Captain Kidd Rd,
Hollywood, SC 29449-6803

Ph: (843) 696-4290
Mr Terry Lee Clark Jr, PA-C
109 Bee St,
Charleston, SC 29401-5703

Ph: (843) 789-7330

Reviews and Comments


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