Healthcare Provider Details

I. General information

NPI: 1932645991
Provider Name (Legal Business Name): HOPEFIELD HEALTHCARE SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2017
Last Update Date: 11/18/2020
Certification Date: 11/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 SANDSTONE CIR
JACKSON TN
38305-2073
US

IV. Provider business mailing address

30 SANDSTONE CIR
JACKSON TN
38305-2073
US

V. Phone/Fax

Practice location:
  • Phone: 731-240-1695
  • Fax: 731-240-1694
Mailing address:
  • Phone: 862-218-1451
  • Fax: 731-240-1694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SYLVESTER A NWEDO
Title or Position: OWNER
Credential: MD
Phone: 862-218-1451