Provider Demographics
NPI:1376735571
Name:HOPKINS, JAMIE A (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:A
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:A
Other - Last Name:PETERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:150 BROOKLYN ST
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18407-2274
Mailing Address - Country:US
Mailing Address - Phone:570-876-6470
Mailing Address - Fax:570-282-7644
Practice Address - Street 1:150 BROOKLYN ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:PA
Practice Address - Zip Code:18407-2274
Practice Address - Country:US
Practice Address - Phone:570-282-7646
Practice Address - Fax:570-282-7644
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013855207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102175125Medicaid
PA127266Medicare PIN