Provider Demographics
NPI:1306816913
Name:HOPKINS, JUDITH O
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:O
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 75216
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-0216
Mailing Address - Country:US
Mailing Address - Phone:336-993-6663
Mailing Address - Fax:336-993-7183
Practice Address - Street 1:1710 KERNERSVILLE MEDICAL PKWY STE 116
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-7156
Practice Address - Country:US
Practice Address - Phone:336-564-4170
Practice Address - Fax:336-564-4936
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23565207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
3098202OtherAETNA HMO
NC43695OtherBLUE CROSS BLUE SHIELD
P00031236OtherRAILROAD MEDICARE
VA006005349Medicaid
4099035OtherAETNA PPO
25571OtherMEDCOST
3601024OtherUNITED HEALTHCARE
NC8943695Medicaid
NC149OtherPARTNERS NATIONAL HEALTH
NC207375DMedicare PIN
3601024OtherUNITED HEALTHCARE
3098202OtherAETNA HMO