Provider Demographics
NPI:1497741334
Name:HOPEWELL, DONALD KIETH (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:KIETH
Last Name:HOPEWELL
Suffix:
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 802843
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-2843
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3801 S NATIONAL AVE STE 900
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5210
Practice Address - Country:US
Practice Address - Phone:417-875-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04202082084N0400X
NJ25MA077957002084N0400X
SC264992084N0400X
AK51792084N0400X
AZ333482084N0400X
FLME897742084N0400X
NY2299892084N0400X
PAMD4226252084N0400X
VA01012356782084N0400X
CT0418882084N0400X
NC2003013622084N0400X
TNMD00000376322084N0400X
NMT200306162084N0400X
MDD00606542084N0400X
MOR4E312084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
185706OtherBCBS
MO202668117Medicaid
222498OtherHEALTHLINK
P00330465OtherRAILROAD MEDICARE
P00330465OtherRAILROAD MEDICARE
MO957423603Medicare PIN