Lusk, Clifford Dale

Lusk, Clifford Dale is an individual health care provider with primary practice located at 101 William H. Johnson Street Suite 200, Florence SC 29506-2776. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Lusk, Clifford Dale can be contacted via phone (843) 777-7500.

Contact Information

Primary practice address
101 William H. Johnson Street Suite 200 Florence SC 29506-2776
Fax: (843) 777-7533
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 16366 South Carolina

Profile Details

NPI number 1508842055
LBN Legal business name Lusk, Clifford Dale
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 16th, 2005
Last updated Feb 12th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508842055 NPPES
South Carolina MEDICAID 163665

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