Provider Demographics
NPI:1689275414
Name:HOPKINS, JAY EDWARD (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:EDWARD
Last Name:HOPKINS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 W DOOLIN AVE
Mailing Address - Street 2:
Mailing Address - City:BLACKWELL
Mailing Address - State:OK
Mailing Address - Zip Code:74631-1351
Mailing Address - Country:US
Mailing Address - Phone:580-363-4090
Mailing Address - Fax:580-363-1390
Practice Address - Street 1:1219 W DOOLIN AVE
Practice Address - Street 2:
Practice Address - City:BLACKWELL
Practice Address - State:OK
Practice Address - Zip Code:74631-1351
Practice Address - Country:US
Practice Address - Phone:580-363-4090
Practice Address - Fax:580-363-1390
Is Sole Proprietor?:No
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15083183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist