Provider Demographics
NPI:1831180785
Name:HOPSON, MARY KATHERINE (PA)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:KATHERINE
Last Name:HOPSON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:KATHERINE
Other - Last Name:WOLTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:100 INDEPENDENCE CIRCLE
Mailing Address - Street 2:ARGYLL MEDICAL GROUP
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-0258
Mailing Address - Country:US
Mailing Address - Phone:530-899-9393
Mailing Address - Fax:530-899-0142
Practice Address - Street 1:100 INDEPENDENCE CIRCLE
Practice Address - Street 2:ARGYLL MEDICAL GROUP
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-0258
Practice Address - Country:US
Practice Address - Phone:530-899-9393
Practice Address - Fax:530-899-0142
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA12458363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
S48573Medicare UPIN
CAS48573Medicare UPIN
CA0PA124581Medicare ID - Type Unspecified