Healthcare Provider Details

I. General information

NPI: 1114110616
Provider Name (Legal Business Name): SHEFFIELD PEDIATRICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2007
Last Update Date: 08/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 MADISON AVE 280
MEMPHIS TN
38104-6492
US

IV. Provider business mailing address

PO BOX 1000, DEPT 854
MEMPHIS TN
38148-0854
US

V. Phone/Fax

Practice location:
  • Phone: 901-259-9200
  • Fax: 901-362-6618
Mailing address:
  • Phone: 901-259-9200
  • Fax: 901-362-6618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35385
License Number StateTN

VIII. Authorized Official

Name: NICOLE M SHEFFIELD
Title or Position: OWNER
Credential: MD
Phone: 901-259-9200