Provider Demographics
NPI:1811596505
Name:HOPSON, LEE ANN (RPH)
Entity type:Individual
Prefix:
First Name:LEE ANN
Middle Name:
Last Name:HOPSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 GLOUCESTER AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLESBORO
Mailing Address - State:KY
Mailing Address - Zip Code:40965-2212
Mailing Address - Country:US
Mailing Address - Phone:606-269-4265
Mailing Address - Fax:
Practice Address - Street 1:515 N 12TH ST
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-1131
Practice Address - Country:US
Practice Address - Phone:606-248-2093
Practice Address - Fax:606-248-0539
Is Sole Proprietor?:No
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0113231835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist