Provider Demographics
NPI:1235352519
Name:DESKINS, AMANDA LEE (DO)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:LEE
Last Name:DESKINS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:LEE
Other - Last Name:BANNISTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:32 CEDAR DR
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9220
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 WHEELING AVE
Practice Address - Street 2:
Practice Address - City:GLEN DALE
Practice Address - State:WV
Practice Address - Zip Code:26038-1697
Practice Address - Country:US
Practice Address - Phone:304-845-3211
Practice Address - Fax:304-843-3202
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2244207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology