Provider Demographics
NPI:1982626339
Name:HOPKINS, GLORIA M (OD)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:M
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 E WALNUT ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5560
Mailing Address - Country:US
Mailing Address - Phone:620-275-7248
Mailing Address - Fax:620-275-5262
Practice Address - Street 1:310 E WALNUT ST
Practice Address - Street 2:SUITE 101
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5560
Practice Address - Country:US
Practice Address - Phone:620-275-7248
Practice Address - Fax:620-275-5262
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14523152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO98014525Medicaid
CO98014525Medicaid
KS049637Medicare ID - Type Unspecified