Provider Demographics
NPI:1619926565
Name:HOPP, LASZLO (MD)
Entity Type:Individual
Prefix:DR
First Name:LASZLO
Middle Name:
Last Name:HOPP
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 15004
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37901
Mailing Address - Country:US
Mailing Address - Phone:865-522-9730
Mailing Address - Fax:865-637-2520
Practice Address - Street 1:2100 W CLINCH AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-2219
Practice Address - Country:US
Practice Address - Phone:865-546-3111
Practice Address - Fax:865-541-8629
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44316208000000X
TNMD00000443162080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1510301Medicaid
TN4217294OtherBCBS
SC576007863047OtherBLUE CHOICE OF SC
SC576007863094OtherBCBS OF SC
SC286023Medicaid
TN4217294OtherBCBS
SC286023Medicaid