Mrs Ky Tai Le Ruiz, AA, PA | |
1700 Medical Way, Snellville, GA 30078-2195 | |
(770) 979-0200 | |
Not Available |
Full Name | Mrs Ky Tai Le Ruiz |
---|---|
Gender | Female |
Speciality | Anesthesiologist Assistant |
Location | 1700 Medical Way, Snellville, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265148068 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367H00000X | Anesthesiologist Assistant | (* (Not Available)) | Primary |
Entity Name | Premier Anesthesia Of Georgia Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1811403207 PECOS PAC ID: 6608123724 Enrollment ID: O20180720001402 |
Mailing Address | Practice Location Address |
---|---|
Mrs Ky Tai Le Ruiz, AA, PA 1704 Creek Mill Trce, Lawrenceville, GA 30044-6184 Ph: (404) 384-8552 | Mrs Ky Tai Le Ruiz, AA, PA 1700 Medical Way, Snellville, GA 30078-2195 Ph: (770) 979-0200 |
William Musarra, A.A. Anesthesiologist Assistant Medicare: Not Enrolled in Medicare Practice Location: 1700 Medical Way, Anesthesia Dept, Snellville, GA 30078 Phone: 770-979-9996 | |
Jeremy L Sterling, PA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 1700 Medical Way, Snellville, GA 30078 Phone: 770-979-9996 Fax: 770-979-1202 | |
Mark C Ankrom, A.A. Anesthesiologist Assistant Medicare: Not Enrolled in Medicare Practice Location: 1700 Medical Way, Snellville, GA 30078 Phone: 770-979-9996 | |
Ermeyas Yehualashet, Anesthesiologist Assistant Medicare: Not Enrolled in Medicare Practice Location: 1700 Medical Way, Snellville, GA 30078 Phone: 770-979-0200 | |
Bianca Patel, Anesthesiologist Assistant Medicare: Not Enrolled in Medicare Practice Location: 1700 Medical Way, Snellville, GA 30078 Phone: 770-979-0200 | |
Stephanie Alyse Patel, AA Anesthesiologist Assistant Medicare: May Accept Medicare Assignments Practice Location: 1700 Medical Way, Anesthesia Department, Snellville, GA 30078 Phone: 770-979-9996 Fax: 770-979-1202 |