Provider Demographics
NPI:1760542575
Name:HOPKINS, MARK D (DC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:D
Last Name:HOPKINS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2390 N ALMA SCHOOL RD STE 115
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-2418
Mailing Address - Country:US
Mailing Address - Phone:480-786-1555
Mailing Address - Fax:480-917-0518
Practice Address - Street 1:2390 N ALMA SCHOOL RD STE 115
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-2418
Practice Address - Country:US
Practice Address - Phone:480-786-1555
Practice Address - Fax:480-917-0518
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3601111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZDC3601Medicare ID - Type Unspecified
AZT32291Medicare UPIN