Provider Demographics
NPI:1467550459
Name:HOPSON, EDWIN SHARP JR (DC)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:SHARP
Last Name:HOPSON
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2100 GARDINER LN
Mailing Address - Street 2:SUITE 317
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-2962
Mailing Address - Country:US
Mailing Address - Phone:502-459-7431
Mailing Address - Fax:502-459-9217
Practice Address - Street 1:2100 GARDINER LN
Practice Address - Street 2:SUITE 317
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2962
Practice Address - Country:US
Practice Address - Phone:502-459-7431
Practice Address - Fax:502-459-9217
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4944111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1223042OtherCHA
KY000000362321OtherANTHEM
KY671426OtherACN/UNITED HEALTHCARE
KY8612024OtherCIGNA
KY000000362321OtherANTHEM