Provider Demographics
NPI:1649436569
Name:BRITT, AMANDA NICOLE (MD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:NICOLE
Last Name:BRITT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:NICOLE
Other - Last Name:POSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:315 FLUKER ST
Mailing Address - Street 2:
Mailing Address - City:THOMSON
Mailing Address - State:GA
Mailing Address - Zip Code:30824-2108
Mailing Address - Country:US
Mailing Address - Phone:706-595-1090
Mailing Address - Fax:706-595-6010
Practice Address - Street 1:2508 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:THOMSON
Practice Address - State:GA
Practice Address - Zip Code:30824-0040
Practice Address - Country:US
Practice Address - Phone:706-595-1090
Practice Address - Fax:706-595-6010
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA079634208000000X
IL125-054976208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA079634OtherSTATE LICENSE
IL125-054976OtherSTATE LICENSE NUMBER
GA003201218AMedicaid