Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 003584 | GA |
Y | 111NI0900X | Internist | 003584 | GA |
NPI | 1003044678 |
---|---|
Provider Name | Amanda Elizabeth Austin |
First Address | Opelika, AL 36801-5454 |
Second Address | Opelika, AL 36801-5454 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2009 |
Last Update Date | 20/02/2013 |