Provider Demographics
NPI:1467656371
Name:HOPKINS, JEFFREY L (CRNA)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:L
Last Name:HOPKINS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 HIGHIAND WAY
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-0000
Mailing Address - Country:US
Mailing Address - Phone:580-467-7185
Mailing Address - Fax:
Practice Address - Street 1:1308 HIGHIAND WAY
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-0000
Practice Address - Country:US
Practice Address - Phone:580-467-7185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX699670367500000X
OK69244367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200129720AMedicaid
OKOKA100045Medicare PIN