Individual
DR. AMANDA LEIGH WITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, DEPARTMENT OF NEUROLOGY, JACKSON, MS 39216-4500
(601) 984-2940
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5500
(601) 984-5503
Taxonomy
Speciality
Code
Description
License number
State
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
Primary
21455
MS
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
A112554
CA
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
N7189
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06252590
—
MS
05
—
157100
—
AL
01
—
P01648523
RAILROAD MEDICARE PTAN
MS
Enumeration date
06/24/2007
Last updated
06/29/2016
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