Dr Lisa Ortenzi, MD | |
880 Crestmark Dr, Suite 200, Lithia Springs, GA 30122-2646 | |
(770) 941-8662 | |
(770) 739-6006 |
Full Name | Dr Lisa Ortenzi |
---|---|
Gender | Female |
Speciality | Obstetrics & Gynecology |
Location | 880 Crestmark Dr, Lithia Springs, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1538153101 | NPI | - | NPPES |
58-1397572 | Other | GA | FEDERAL TAX ID# |
00405358A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207V00000X | Obstetrics & Gynecology | 023395 (Georgia) | Primary |
Entity Name | Douglas Womens Center Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1407840069 PECOS PAC ID: 0840285573 Enrollment ID: O20040420000795 |
Mailing Address | Practice Location Address |
---|---|
Dr Lisa Ortenzi, MD 880 Crestmark Dr, Suite 200, Lithia Springs, GA 30122-2646 Ph: (770) 941-8662 | Dr Lisa Ortenzi, MD 880 Crestmark Dr, Suite 200, Lithia Springs, GA 30122-2646 Ph: (770) 941-8662 |
Suzanne Lee Lowry, M.D. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 939 Bob Arnold Blvd, Suite A, Lithia Springs, GA 30122 Phone: 770-732-2959 Fax: 770-732-2947 | |
Raj Kumar Bansal, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 870 Crestmark Dr, Ste 201, Lithia Springs, GA 30122 Phone: 770-739-5242 Fax: 770-739-5204 | |
Jeffrey A Bradley, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 870 Crestmark Dr Ste 203, Lithia Springs, GA 30122 Phone: 470-881-8757 | |
Linda Dianne Ford, M.D. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 939 Bob Arnold Blvd, Suite A, Lithia Springs, GA 30122 Phone: 770-944-9852 Fax: 770-944-1043 |