Provider Demographics
NPI:1487085718
Name:HOPKINS, TERESA (OPTICIAN)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:COFFEYVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67337-5829
Mailing Address - Country:US
Mailing Address - Phone:620-515-4272
Mailing Address - Fax:620-251-4498
Practice Address - Street 1:316 W 8TH ST
Practice Address - Street 2:
Practice Address - City:COFFEYVILLE
Practice Address - State:KS
Practice Address - Zip Code:67337-5829
Practice Address - Country:US
Practice Address - Phone:620-515-4272
Practice Address - Fax:620-251-4498
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician