Individual
DR. AMANDA JUSTINE HUTCHINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
600 CELEBRATE LIFE PKWY, NEWNAN, GA 30265-8001
(770) 400-6440
Mailing address
PO BOX 98978, LAS VEGAS, NV 89193-8978
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17426
NV
207Q00000X
Family Medicine Physician
45479
TN
207Q00000X
Family Medicine Physician
69055
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17426
STATE LICENSE
NV
05
—
1861600975
—
NV
01
—
69055
STATE LICENSE
GA
Enumeration date
05/21/2007
Last updated
02/15/2024
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