Provider Demographics
NPI:1144226465
Name:HOPKINS, TAMARA VANN (MD)
Entity Type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:VANN
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 104240
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65110-4240
Mailing Address - Country:US
Mailing Address - Phone:573-556-5771
Mailing Address - Fax:573-636-9756
Practice Address - Street 1:1241 W. STADIUM BLVD.
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-6023
Practice Address - Country:US
Practice Address - Phone:573-556-7718
Practice Address - Fax:573-556-1701
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2023-06-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO112841207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO203932405Medicaid
MO203932405Medicaid
MOG89560Medicare UPIN
MO934165236Medicare PIN