DR. DRAZEN M JUKIC (NPI# 1134193774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134193774 |
| Entity Type | Individual |
| Full Name | DR. DRAZEN M JUKIC |
| Credential | MD, PHD |
| Practice Address |
5400 Sutlive St Suite 3 Savannah GA 31405-4721 |
| Mailing Address |
2400 Bellevue Rd Suite 21-a Dublin GA 31021-2885 |
| Practice Telephone | 9122327546 |
| Practice Fax Number | 9127777798 |
| Mailing Telephone | 4782757202 |
| Mailing Fax Number | 4782748418 |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2015-11-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZD0900X |
Pathology Specialization: Dermatopathology |
056878 | GA | Allopathic & Osteopathic Physicians |
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
056878 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 003007800 | 05 | |
| GA | 003140616 | 05 | |
| FL | BLUE CROSS BLUE SHIELD | 149H6 | 01 |
| GA | GEORGIA LICENSE | 056878 | 01 |
| Street Address |
5400 SUTLIVE ST SUITE 3 |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31405-4721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497377097 | Julia Spruill-mote | Physician Assistant | 5400 Sutlive St, Savannah, GA 31405-4721 | 2020-05-18 |
| 1982225884 | Amy Carter | Nurse Practitioner | 5400 Sutlive St, Savannah, GA 31405-4721 | 2020-05-01 |
| 1689234163 | Vanessa Fitch Brink | Nurse Practitioner | 5400 Sutlive St, Savannah, GA 31405-4721 | 2019-06-18 |
| 1851951339 | Nicole Avendano Mitchell | Nurse Practitioner | 5400 Sutlive St, Savannah, GA 31405-4721 | 2019-06-18 |
| 1386174613 | Kelsey Fowler Cameron | Physician Assistant | 5400 Sutlive St, Savannah, GA 31405-4721 | 2017-06-19 |
| 1669573606 | Myra T. Buskirk | Nurse Practitioner | 5400 Sutlive St, Savannah, GA 31405-4721 | 2006-09-25 |
| 1265486229 | Stephen A White | Internal Medicine | 5400 Sutlive St, Savannah, GA 31405-4721 | 2006-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053918441 | Nicole Marie Tetro | Anesthesiology | Candler Hospital, 5353 Reynolds St, Savannah, GA 31405 | 2020-10-08 |
| 1154983880 | Nickes Medical Supply, LLC. | Durable Medical Equipment & Medical Supplies | 6020 Halsey St, Savannah, GA 31405 | 2019-07-02 |
| 1215593025 | Lee Ann Ryle | Nurse Practitioner | 5223 Paulsen St., Savannah, GA 31405 | 2019-05-16 |
| 1942765334 | Raegan Epps | Behavior Technician | 613 Stephenson Ave Ste 205, Savannah, GA 31405 | 2019-02-10 |
| 1679050454 | Phenomenal Nursing Service | Registered Nurse | 604 South St., 604 South St, Savannah, GA 31405 | 2018-07-24 |
| 1275029472 | Chelsea Amanda Keedy | Pharmacist | 836 E. 65th St., Medical Arts #4, Savannah, GA 31405 | 2018-07-11 |
| 1265933840 | Dwc-p LLC | Dentist | 5209 Paulsen Street, Savannah, GA 31405 | 2018-02-28 |
| 1386153005 | Aaron Shaw | Hearing Instrument Specialist | 5501 Abercorn St Ste E, Savannah, GA 31405 | 2017-09-26 |
| 1063946028 | Elizabeth Bentley Bruhn-danello | Dietitian, Registered | 836 East 65th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-17 |
| 1396278230 | Theresa Lynn George | Health Educator | 836 East 65 Th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-07 |
| Find all providers in zip 31405 | ||||
| Taxonomy Code | 207ZD0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Dermatopathology |
| A dermatopathologist is an expert in diagnosing and monitoring diseases of the skin including infectious, immunologic, degenerative, and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings, and smears of skin lesions by means of light microscopy, electron microscopy, and fluorescence microscopy. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source added] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. A subspecialty certificate was first issued by the ABMS in 1974. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871630350 | Seth Ian Rosenthal | Pathology | 1901 Phoenix Blvd Ste 210, Atlanta, GA 30349-5062 | 2007-01-31 |
| 1780623785 | Jessie Lee | Pathology | 175 White St Nw, Suite 370, Marietta, GA 30060-1053 | 2006-06-05 |
| 1295798320 | Wayne L Bakotic | Pathology | 114 Mimosa Dr, Suite C, Thomasville, GA 31792-6677 | 2006-04-10 |
| 1639158389 | Scott M Acker | Pathology | 6240 Shiloh Rd Ste B, Alpharetta, GA 30005-8347 | 2006-01-11 |
| 1295710754 | Bradley W. Bakotic | Pathology | 2001 Westside Parkway, Suite 290, Alpharetta, GA 30004-8514 | 2005-12-07 |
| 1093797144 | Michael J Palko IIi | Pathology | 510 E Oglethorpe Hwy, Hinesville, GA 31313 | 2005-11-15 |
| 1053392191 | Ling Chen | Pathology | 1951 Clairmont Rd, Decatur, GA 30033-3415 | 2005-11-07 |
| 1649270885 | Jordan H. Berne | Pathology | 6095 Barfield Rd Ne, Suite 200, Atlanta, GA 30328-4408 | 2005-07-29 |
| 1588667380 | Christopher J Kligora | Pathology | 311 W 8th St Ne, Rome, GA 30165-2723 | 2005-05-24 |
| 1912900697 | Steve M Covington IIi | Pathology | 2701 N Decatur Rd, Decatur, GA 30033-5918 | 2005-05-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.