Healthcare Provider Details

I. General information

NPI: 1285098368
Provider Name (Legal Business Name): AMANDA JANE ANDREWS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2016
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 15TH ST
AUGUSTA GA
30912-5704
US

IV. Provider business mailing address

863 W OGLETHORPE HWY STE 220
HINESVILLE GA
31313-4491
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-8623
  • Fax: 706-721-1459
Mailing address:
  • Phone: 912-391-1044
  • Fax: 912-307-3844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number97118
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number97118
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: