| Dr Michael K Kizziah, MD | |
|
255 W 5th St Sw, Suite 150, Rome, GA 30165-2817 | |
| (706) 232-1545 | |
| (706) 232-3819 |
| Full Name | Dr Michael K Kizziah |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 20 Years |
| Location | 255 W 5th St Sw, Rome, Georgia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124108923 | NPI | - | NPPES |
| 003123794B | Medicaid | GA | |
| 279442 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085B0100X | Radiology - Body Imaging | 27944 (South Carolina) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 065694 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Union General Hospital | Blairsville, GA | Hospital |
| Tift Regional Medical Center | Tifton, GA | Hospital |
| Floyd Medical Center | Rome, GA | Hospital |
| Redmond Regional Medical Center | Rome, GA | Hospital |
| Adventhealth Gordon | Calhoun, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| South Georgia Radiology Associates Llc | 0042389231 | 34 |
| Harbin Clinic Llc | 0446154231 | 249 |
| Rome Imaging Associates | 8820089121 | 7 |
| Rome Radiology Group Pa | 8921091695 | 23 |
| Rome Radiology Group Pa | 8921091695 | 23 |
| Entity Name | Harbin Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679599088 PECOS PAC ID: 0446154231 Enrollment ID: O20031124000117 |
| Entity Name | Rome Radiology Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952330615 PECOS PAC ID: 8921091695 Enrollment ID: O20040407000833 |
| Entity Name | Rome Imaging Associates |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013923820 PECOS PAC ID: 8820089121 Enrollment ID: O20040524000830 |
| Entity Name | South Georgia Radiology Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760669931 PECOS PAC ID: 0042389231 Enrollment ID: O20080514000110 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael K Kizziah, MD Po Box 369, Rome, GA 30162-0369 Ph: (706) 291-2661 | Dr Michael K Kizziah, MD 255 W 5th St Sw, Suite 150, Rome, GA 30165-2817 Ph: (706) 232-1545 |
Dr. Steven W Pruett, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1104 Martha Berry Blvd Ne, Rome, GA 30165 Phone: 706-291-2077 Fax: 706-235-4177 | |
Matthew Peter Mumber, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 255 W 5th St Sw, Rome, GA 30165 Phone: 706-234-1400 Fax: 706-232-5018 | |
Dr. Chad Harple, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 901 N Broad St Ne, Rome, GA 30161 Phone: 706-291-2661 | |
William P Harbin Ii, Radiology Medicare: Medicare Enrolled Practice Location: 901 N Broad St Ne, Suite 220, Rome, GA 30161 Phone: 706-291-2077 | |
J. Daniel Hanks Jr., Radiology Medicare: Not Enrolled in Medicare Practice Location: 1104 Martha Berry Blvd Ne, Rome, GA 30165 Phone: 706-291-2077 | |
John Christopher Abdou, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 255 W 5th St Sw, Rome, GA 30165 Phone: 706-234-1400 Fax: 706-232-5018 |