MEDICARE: CARLEE DEE BRIGHT PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	977	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255372637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLEE DEE BRIGHT PA-C

Provider Business Mailing Address
First Line	:	115 ROSEBERRY HILL DR
Second Line	:
City	:	LYMAN
State	:	SC
Zip	:	29365-9338
Country	:	US
Telephone Number	:	864-357-1566
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 SKYLYN DR STE 210
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29307-1069
Country	:	US
Telephone Number	:	864-671-6492
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	04/07/2025

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Directions to “ CARLEE DEE BRIGHT PA-C” Practice Location

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