Provider Demographics
NPI:1376511212
Name:HOPPERS, JAMES W JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:HOPPERS
Suffix:JR
Gender:M
Credentials:MD
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 12197
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38308-0136
Mailing Address - Country:US
Mailing Address - Phone:731-984-8400
Mailing Address - Fax:731-984-8305
Practice Address - Street 1:2075 PLEASANT PLAINS EXTENDED
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305
Practice Address - Country:US
Practice Address - Phone:731-984-8400
Practice Address - Fax:731-984-8305
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD12124208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3835360Medicaid
TN3835360Medicare ID - Type UnspecifiedMEDICARE
TN3835360Medicaid