Provider Demographics
NPI:1548329857
Name:HOPSON, DEANNA LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:LYNN
Last Name:HOPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S. TIMBERLANE DRIVE
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-4519
Mailing Address - Country:US
Mailing Address - Phone:870-862-2400
Mailing Address - Fax:870-862-1891
Practice Address - Street 1:600 S TIMBERLANE DRIVE
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-4519
Practice Address - Country:US
Practice Address - Phone:870-862-2400
Practice Address - Fax:870-862-1891
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC 7493207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR120553001Medicaid
AR54231OtherPART B BCBS INDIV PROV NO
ARE54511Medicare UPIN