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General NPI Number Information
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NPI Number | 1386164465
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Entity Type | Individual
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Provider Name | ALDINA JAKUPOVIC OD
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Gender | Female
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Dates
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Enumeration Date | 06/21/2017
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Last Update Date | 09/14/2021
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Provider Practice Location Address
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Address Line | 901 ABERNATHY RD STE 100
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City | SANDY SPRINGS
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State | GA
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Zip | 30328-2561
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Country | US
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Telephone | 404-252-1702
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Fax | 404-303-8843
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Provider Business Mailing Address
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Address Line | 849 WYTOWER TRL
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City | NORCROSS
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State | GA
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Zip | 30093-4159
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Country | US
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Telephone | 470-262-8571
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT003027
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License Number State | GA
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