Provider Demographics
NPI:1932658366
Name:GOLUBOVIC, VESNA
Entity Type:Individual
Prefix:DR
First Name:VESNA
Middle Name:
Last Name:GOLUBOVIC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4838 POPLAR LEVEL RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40213-2904
Mailing Address - Country:US
Mailing Address - Phone:502-969-1695
Mailing Address - Fax:
Practice Address - Street 1:4838 POPLAR LEVEL RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40213-2904
Practice Address - Country:US
Practice Address - Phone:502-969-1695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY018309183500000X
MAPH235223183500000X
FLPS52069183500000X
TN000040043183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist