Provider Demographics
NPI:1871767152
Name:CLEVELAND, AMY LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:LYNN
Last Name:CLEVELAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 749495
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9495
Mailing Address - Country:US
Mailing Address - Phone:239-432-8331
Mailing Address - Fax:
Practice Address - Street 1:1455 HIGDON FERRY RD
Practice Address - Street 2:HOT SPRINGS
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6419
Practice Address - Country:US
Practice Address - Phone:501-623-2731
Practice Address - Fax:501-623-1660
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-7370207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR204150001Medicaid