Provider Demographics
NPI:1457594814
Name:TAMARA V. HOPKINS, M.D., L.L.C.
Entity Type:Organization
Organization Name:TAMARA V. HOPKINS, M.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:V
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:573-634-7154
Mailing Address - Street 1:2009 SAINT MARYS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-1509
Mailing Address - Country:US
Mailing Address - Phone:573-634-7154
Mailing Address - Fax:573-634-3146
Practice Address - Street 1:1705 CHRISTY DR
Practice Address - Street 2:SUITE 201
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101-5195
Practice Address - Country:US
Practice Address - Phone:573-634-7155
Practice Address - Fax:573-634-3146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMD112841207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty