Individual
AMANDA DAWN SELLERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
421 S 28TH AVE, SUITE 200, HATTIESBURG, MS 39401-7206
(601) 268-5640
(601) 261-3507
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5640
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
24300
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02628230
—
MS
Enumeration date
06/29/2012
Last updated
08/11/2020
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