Provider Demographics
NPI:1952875411
Name:HOPSON, RONALD EARL
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:EARL
Last Name:HOPSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4964 AVI DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-5968
Mailing Address - Country:US
Mailing Address - Phone:901-690-6069
Mailing Address - Fax:
Practice Address - Street 1:4964 AVI DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38002-5968
Practice Address - Country:US
Practice Address - Phone:901-690-6069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-17
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN055229708343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)