Provider Demographics
NPI:1437167269
Name:STOJANOVIC, SMILJKA (MD)
Entity Type:Individual
Prefix:DR
First Name:SMILJKA
Middle Name:
Last Name:STOJANOVIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 REES ST
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31709-3753
Mailing Address - Country:US
Mailing Address - Phone:229-924-8001
Mailing Address - Fax:
Practice Address - Street 1:206 REES ST
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709-3753
Practice Address - Country:US
Practice Address - Phone:229-924-8001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2011-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA058223207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I111530OtherMEDICARE PTAN
GA003105027AMedicaid