Provider Demographics
NPI:1326879693
Name:SMAJLOVIC, AJLA
Entity type:Individual
Prefix:
First Name:AJLA
Middle Name:
Last Name:SMAJLOVIC
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 1:3307 MOULTON LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-1208
Mailing Address - Country:US
Mailing Address - Phone:502-645-4824
Mailing Address - Fax:
Practice Address - Street 1:3307 MOULTON LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-1208
Practice Address - Country:US
Practice Address - Phone:502-645-4824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program