Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bull St District Family Practice LLC

Organization Adult Medicine Physician · NPI 1265232326

Bull St District Family Practice LLC is an Adult Medicine Physician in Columbia, South Carolina. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1417 Gregg St
Columbia, SC 29201-3527
Phone: (803) 915-0469
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Medicine Physician (primary) Taxonomy 207QA0505X

Record details

NPI number1265232326
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cornell Clark — Managing Director · (702) 904-4077
Other names Bull St District Family Practice; Cornell M. Clark, M.D.
NPI enumeratedMarch 18, 2025
Last updated in NPPESMarch 18, 2025
Certification dateMarch 18, 2025
Mailing addressPo Box 99, Columbia, SC 29202-0099

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