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Organization
LOWCOUNTRY NEUROPATHY OF BEAUFORT LLC
Active
Organization
LOWCOUNTRY NEUROPATHY OF BEAUFORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM MARK LUCKIE (PARTNER)
(843) 817-7404
Entity
Organization
Contact information
Practice address
1264 RIBAUT RD, BEAUFORT, SC 29902-6123
(843) 817-7404
(843) 529-0234
Mailing address
4222 FLYNN DR, NORTH CHARLESTON, SC 29405-6784
(843) 817-7404
(843) 529-0234
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23765
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427030212
PROVIDER NPI
SC
Enumeration date
08/31/2012
Last updated
08/31/2012
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