Antic, Goran Djordje

Antic, Goran Djordje is an individual health care provider with primary practice located at 1265 E College St , Pulaski TN 38478-4541. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Antic, Goran Djordje can be contacted via phone (931) 363-7531.

Contact Information

Primary practice address
1265 E College St Pulaski TN 38478-4541
Phone: (931) 363-7531
Fax: (865) 291-3228
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 34506 Tennessee

Profile Details

NPI number 1124074752
LBN Legal business name Antic, Goran Djordje
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2006
Last updated Nov 6th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124074752 NPPES
Tennessee Other P00372629 RAILROAD MEDICARE
Tennessee MEDICAID 3859664 RAILROAD MEDICARE
Tennessee Other 4072313 RAILROAD MEDICARE

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