Organization · Type 2 NPI

Lifesource Prime Inc

Family Medicine Physician · Clinton, SC

NPI number 1851143523 Active

Practice location

939 Springdale Dr
Clinton, SC 29325-7266

Fax (888) 746-1787

Mailing address

PO Box 740343
Atlanta, GA 30374-0343

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician Primary 207Q00000XNone listed
Internal Medicine Physician 207R00000XNone listed
General Practice Physician 208D00000XNone listed
Physician Assistant 363A00000XNone listed
Nurse Practitioner 363L00000XNone listed
Family Nurse Practitioner 363LF0000XNone listed
Gerontology Nurse Practitioner 363LG0600XNone listed
Primary Care Nurse Practitioner 363LP2300XNone listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

12 other providers at this address

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About NPI 1851143523

Lifesource Prime Inc's National Provider Identifier is 1851143523, issued on Apr 4, 2024. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Clinton, SC. The record was last updated on Oct 28, 2025.