Provider Demographics
NPI:1083686265
Name:HOPKINS, III, ELWOOD WILBUR (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:ELWOOD
Middle Name:WILBUR
Last Name:HOPKINS, III
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
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Mailing Address - Street 1:269 S CANDY LN
Mailing Address - Street 2:ATTN: MEDICAL STAFF SERVICE
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-4158
Mailing Address - Country:US
Mailing Address - Phone:928-649-7991
Mailing Address - Fax:
Practice Address - Street 1:450 S WILLARD ST
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-6743
Practice Address - Country:US
Practice Address - Phone:928-649-7991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG353782084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG35378OtherMEDICAL LICENSE