Healthcare Provider Details

I. General information

NPI: 1417884735
Provider Name (Legal Business Name): OLIVER HOUSTON HOPKINS III
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: HOP HOPKINS

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 COBBLESTONE CT
MADISON MS
39110-7570
US

IV. Provider business mailing address

505 COBBLESTONE CT
MADISON MS
39110-7570
US

V. Phone/Fax

Practice location:
  • Phone: 601-620-9894
  • Fax:
Mailing address:
  • Phone: 601-620-9894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: