Individual
PAUL M NOVAKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 S FARMERVILLE ST, RUSTON, LA 71270-5941
(318) 255-3690
(318) 251-6177
Mailing address
1200 S FARMERVILLE ST, RUSTON, LA 71270-5941
(318) 255-3690
(318) 251-6177
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME108790
FL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
205711
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003720500
—
FL
05
—
129805
—
AL
05
—
129809
—
AL
01
—
14E9E
BLUE CROSS BLUE SHIELD
FL
01
—
593-07447
BLUE CROSS BLUE SHIELD
AL
01
—
593-07448
BLUE CROSS BLUE SHIELD
AL
Enumeration date
05/21/2007
Last updated
04/12/2017
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