| Danielle T Cappelletti, MD | |
|
100 Jackson Pike, Gallipolis, OH 45631-1560 | |
| (740) 446-5371 | |
| (740) 446-5711 |
| Full Name | Danielle T Cappelletti |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 100 Jackson Pike, Gallipolis, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255362927 | NPI | - | NPPES |
| 3810006341 | Medicaid | WV | |
| 001895230 | Other | MOUNTAIN STATE BCBS | |
| 000000502440 | Other | ANTHEM BCBS | |
| 2704505 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 22601 (West Virginia) | Secondary |
| 208000000X | Pediatrics | 085786 (Ohio) | Primary |
| Entity Name | Holzer Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508817248 PECOS PAC ID: 5890606008 Enrollment ID: O20031215000746 |
| Mailing Address | Practice Location Address |
|---|---|
| Danielle T Cappelletti, MD 90 Jackson Pike, Gallipolis, OH 45631-1560 Ph: (740) 446-5371 | Danielle T Cappelletti, MD 100 Jackson Pike, Gallipolis, OH 45631-1560 Ph: (740) 446-5371 |
Jon M. Sullivan, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 100 Jackson Pike, Gallipolis, OH 45631 Phone: 740-446-5371 Fax: 740-446-5711 | |
Jonathan Mathis, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 100 Jackson Pike, Gallipolis, OH 45631 Phone: 855-446-5937 Fax: 740-446-5711 | |
Marina D. Burgess, FNP-C Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 100 Jackson Pike, Gallipolis, OH 45631 Phone: 855-446-5937 | |
Mr. Jacob Lawrence Pessia, MS IV Pediatrics Medicare: Medicare Enrolled Practice Location: 100 Jackson Pike, Gallipolis, OH 45631 Phone: 740-441-1949 Fax: 740-446-5982 | |
Shana Allie Vore, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 100 Jackson Pike, Gallipolis, OH 45631 Phone: 855-446-5937 Fax: 740-446-5711 | |
Pradeep K. Kandula, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 100 Jackson Pike, Gallipolis, OH 45631 Phone: 740-446-5371 Fax: 740-446-5711 |