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NPI Code Detail

MEDICARE: AMANDA CUMMINS DO

MEDICARE: AMANDA CUMMINS DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramGA
2207Q00000XFamily Medicine Physician2657TN

General Provider Information

NPI Number : 1477846681
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA CUMMINS DO
Provider Business Mailing Address
First Line : 331 LANDRUM PL
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37043-6329
Country : US
Telephone Number : 931-502-2383
Fax Number : 931-502-2384
Provider Business Practice Location Address
First Line : 331 LANDRUM PL
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37043-6329
Country : US
Telephone Number : 931-502-2383
Fax Number : 931-502-2384
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2011
Last Update Date : 10/30/2014

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Directions to “ AMANDA CUMMINS DO” Practice Location

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