Provider Demographics
NPI:1811271083
Name:BEARD, JASNA IKANOVIC (MD)
Entity type:Individual
Prefix:DR
First Name:JASNA
Middle Name:IKANOVIC
Last Name:BEARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JASNA
Other - Middle Name:
Other - Last Name:IKANOVIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5673 PEACHTREE DUNWOODY RD STE 500
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-2147
Mailing Address - Country:US
Mailing Address - Phone:404-251-2400
Mailing Address - Fax:
Practice Address - Street 1:5673 PEACHTREE DUNWOODY RD STE 500
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-2147
Practice Address - Country:US
Practice Address - Phone:404-251-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA84277207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology