Provider Demographics
NPI:1427273630
Name:JACK E. HOPKINS, O.D., INC.
Entity type:Organization
Organization Name:JACK E. HOPKINS, O.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:405-737-8935
Mailing Address - Street 1:8121 NATIONAL AVE
Mailing Address - Street 2:STE 409
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-7530
Mailing Address - Country:US
Mailing Address - Phone:405-737-8935
Mailing Address - Fax:405-737-8934
Practice Address - Street 1:8121 NATIONAL AVE
Practice Address - Street 2:STE 409
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-7530
Practice Address - Country:US
Practice Address - Phone:405-737-8935
Practice Address - Fax:405-737-8934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-14
Last Update Date:2018-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK860152W00000X, 152WC0802X, 152WP0200X, 332H00000X
152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK410020540OtherRAILROAD MEDICARE
OK100765510AMedicaid
OKT40508Medicare UPIN
OK100765510AMedicaid