Provider Demographics
NPI:1104834241
Name:HOPKINS, KRISTINE T (OD)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:T
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:T
Other - Last Name:BECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1716 UNIVERSITY BLVD
Mailing Address - Street 2:HBP G080A
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294-0010
Mailing Address - Country:US
Mailing Address - Phone:205-975-2020
Mailing Address - Fax:205-934-6755
Practice Address - Street 1:1716 UNIVERSITY BLVD
Practice Address - Street 2:HBP G080A
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-0010
Practice Address - Country:US
Practice Address - Phone:205-975-2020
Practice Address - Fax:205-934-6755
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-B03-TA-433152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U77718OtherVIVA HEALTH
AL000051698Medicaid
AL410042858OtherRR MEDICARE
1716A 636005396OtherVISION SERVICES PLAN
MS00804258Medicaid
AL051051698OtherBLUE CROSS BLUE SHIELD
LA1586005Medicaid
AL51542386OtherBCBS OF ALABAMA
MS00804258Medicaid
0279620003Medicare NSC
AL051559669Medicare PIN
0279620004Medicare NSC
U77718Medicare UPIN