Provider Demographics
NPI:1255365847
Name:HOPKINS, DONALD ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:ANDREW
Last Name:HOPKINS
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 1810
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39502-1810
Mailing Address - Country:US
Mailing Address - Phone:228-865-1453
Mailing Address - Fax:228-865-1457
Practice Address - Street 1:1312 44TH AVE
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-2552
Practice Address - Country:US
Practice Address - Phone:228-868-8565
Practice Address - Fax:228-868-2170
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS04990174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00011948Medicaid
MS00011948Medicaid
MSD82450Medicare UPIN
MS020000148Medicare ID - Type Unspecified