Provider Demographics
NPI:1609015205
Name:DAVID C HOPKINS PHD PC
Entity Type:Organization
Organization Name:DAVID C HOPKINS PHD PC
Other - Org Name:CONSULTING NEUROPSYCHOLOGY/REHABILITATION PSYCHOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:719-314-7774
Mailing Address - Street 1:1372 LINDENWOOD GRV
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-7605
Mailing Address - Country:US
Mailing Address - Phone:719-314-7773
Mailing Address - Fax:719-636-8989
Practice Address - Street 1:224 E WILLAMETTE AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-1114
Practice Address - Country:US
Practice Address - Phone:719-314-7773
Practice Address - Fax:719-636-8989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2290103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
680011216OtherRAIL ROAD MEDICARE
680011216OtherRAIL ROAD MEDICARE
69976Medicare PIN