Dr Isabella Zita Ricketts, MD | |
1300 Ridenour Blvd Nw, Mak Anesthesia, Kennesaw, GA 30152-4501 | |
(770) 702-1806 | |
(770) 693-0810 |
Full Name | Dr Isabella Zita Ricketts |
---|---|
Gender | Female |
Speciality | Anesthesiology |
Experience | 14 Years |
Location | 1300 Ridenour Blvd Nw, Kennesaw, Georgia |
Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1558672782 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | 77276 (Georgia) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Wellstar Cobb Hospital | Austell, GA | Hospital |
Wellstar North Fulton Hospital | Roswell, GA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Mak Anesthesia Holdings, Llc | 4284917204 | 170 |
Mak Anesthesia Northside Affiliates Llc | 7315203718 | 38 |
Entity Name | Mak Anesthesia Holdings, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1912452939 PECOS PAC ID: 4284917204 Enrollment ID: O20170216001563 |
Entity Name | Mak Anesthesia Northside Affiliates Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1609390103 PECOS PAC ID: 7315203718 Enrollment ID: O20171116002499 |
Mailing Address | Practice Location Address |
---|---|
Dr Isabella Zita Ricketts, MD 1300 Ridenour Blvd Nw, Mak Anesthesia, Kennesaw, GA 30152-4501 Ph: (770) 702-1806 | Dr Isabella Zita Ricketts, MD 1300 Ridenour Blvd Nw, Mak Anesthesia, Kennesaw, GA 30152-4501 Ph: (770) 702-1806 |
Russell H Blocker, PAAA Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1640 Airport Rd Nw, Ste. 110, Kennesaw, GA 30144 Phone: 678-202-2074 Fax: 678-290-0479 | |
Walter H Butler, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1640 Airport Rd Nw, Ste 110, Kennesaw, GA 30144 Phone: 678-202-2074 Fax: 770-590-1442 | |
Melody Bolton, Anesthesiology Medicare: May Accept Medicare Assignments Practice Location: 1300 Ridenour Blvd Nw Ste 300, Kennesaw, GA 30152 Phone: 985-722-7993 | |
Christopher W Stowell, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 3450 Acworth Due West Rd Nw Ste 200, Kennesaw, GA 30144 Phone: 770-794-6643 Fax: 770-794-6683 | |
Henry Rachal Iii, M.D. Anesthesiology Medicare: May Accept Medicare Assignments Practice Location: 1300 Ridenour Blvd Nw Ste 300, Kennesaw, GA 30152 Phone: 770-693-0810 | |
Dr. Grant Adam Doornbos, M.D. Anesthesiology Medicare: May Accept Medicare Assignments Practice Location: 1300 Ridenour Blvd Nw Ste 300, Kennesaw, GA 30152 Phone: 770-702-1806 | |
James Michael Ditolla, D.O. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1275 Shiloh Rd Nw Ste 2120, Kennesaw, GA 30144 Phone: 631-671-1194 |