| 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 | 15 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 |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mak Anesthesia Holdings, Llc | 4284917204 | 169 |
| Mak Anesthesia Georgia, Llc | 7315203718 | 92 |
| 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: Accepting 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 | |
Scott Edward Bisch, Anesthesiology Medicare: May Accept Medicare Assignments Practice Location: 1300 Ridenour Blvd Nw Ste 300, Kennesaw, GA 30152 Phone: 803-257-7481 |