Provider Demographics
NPI:1891763744
Name:LOVREKOVIC-ZAKULA, GORDANA (MD)
Entity Type:Individual
Prefix:DR
First Name:GORDANA
Middle Name:
Last Name:LOVREKOVIC-ZAKULA
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 1:4750 WATERS AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-6200
Mailing Address - Country:US
Mailing Address - Phone:912-721-0050
Mailing Address - Fax:912-721-0051
Practice Address - Street 1:4750 WATERS AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-6200
Practice Address - Country:US
Practice Address - Phone:912-721-0050
Practice Address - Fax:912-721-0051
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0504042080P0214X, 2080S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000910962AMedicaid
GA000910962GMedicaid
GA000910962AMedicaid