| Goran Djordje Antic, MD | |
|
1265 E College St, Pulaski, TN 38478-4541 | |
| (931) 363-7531 | |
| (865) 291-3228 |
| Full Name | Goran Djordje Antic |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 1265 E College St, Pulaski, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124074752 | NPI | - | NPPES |
| P00372629 | Other | TN | RAILROAD MEDICARE |
| 3859664 | Medicaid | TN | |
| 4072313 | Other | TN | BCBSTN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 34506 (Tennessee) | Primary |
| Entity Name | Emergency Coverage Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427005008 PECOS PAC ID: 3072412592 Enrollment ID: O20050207000666 |
| Mailing Address | Practice Location Address |
|---|---|
| Goran Djordje Antic, MD Po Box 636019, Cincinnati, OH 45263-6019 Ph: () - | Goran Djordje Antic, MD 1265 E College St, Pulaski, TN 38478-4541 Ph: (931) 363-7531 |
Allen Honig, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1265 E College St, Pulaski, TN 38478 Phone: 931-363-7531 Fax: 865-291-3228 | |
Dr. Matthew Jesse Burns, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1265 E College St, Pulaski, TN 38478 Phone: 931-363-7531 | |
Dr. Purushothaman Madhu, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1265 E College St, Pulaski, TN 38478 Phone: 931-363-7531 |