| Barry M Zisholtz, MD | |
|
33 Upper Riverdale Rd Sw, Suite 105, Riverdale, GA 30274-2626 | |
| (770) 991-0020 | |
| (770) 994-9729 |
| Full Name | Barry M Zisholtz |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Location | 33 Upper Riverdale Rd Sw, Riverdale, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265441349 | NPI | - | NPPES |
| 340008499 | Other | GA | RAILROAD MEDICARE |
| 000441867A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 030698 (Georgia) | Primary |
| Entity Name | Georgia Urology, Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245250646 PECOS PAC ID: 8921094376 Enrollment ID: O20040422000123 |
| Entity Name | Urological Professional Services, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033521810 PECOS PAC ID: 9638391717 Enrollment ID: O20141104002579 |
| Mailing Address | Practice Location Address |
|---|---|
| Barry M Zisholtz, MD 1930 Brannan Rd, Mcdonough, GA 30253-4310 Ph: (678) 284-4040 | Barry M Zisholtz, MD 33 Upper Riverdale Rd Sw, Suite 105, Riverdale, GA 30274-2626 Ph: (770) 991-0020 |
Darrell J Carmen, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 33 Upper Riverdale Rd Sw, Suite 105, Riverdale, GA 30274 Phone: 770-991-0020 Fax: 770-994-9729 | |
Zachary L Voeltz, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 81 Upper Riverdale Rd Sw, Suite 200, Riverdale, GA 30274 Phone: 770-991-0020 Fax: 770-994-9729 | |
Ayodeji Sotimehin, Urology Medicare: May Accept Medicare Assignments Practice Location: 33 Upper Riverdale Rd Sw Ste 105, Riverdale, GA 30274 Phone: 770-991-0020 Fax: 770-994-9729 | |
Dr. Krishan G Gupta, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 150 Medical Way, Riverdale, GA 30274 Phone: 770-991-6364 Fax: 770-991-6473 |