Healthcare Provider Details

I. General information

NPI: 1689060402
Provider Name (Legal Business Name): AMANDA TAPLEY MCGRIFF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2015
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 TOWN PARK BLVD
EVANS GA
30809-3487
US

IV. Provider business mailing address

339 BELLA ROSE DR
EVANS GA
30809-0389
US

V. Phone/Fax

Practice location:
  • Phone: 706-854-2500
  • Fax: 706-854-2559
Mailing address:
  • Phone: 205-908-4685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number103753
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35701
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number103753
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: