Healthcare Provider Details

I. General information

NPI: 1104890466
Provider Name (Legal Business Name): JOHN J. HOPKINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 12/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9250 N 3RD ST SUITE 2000
PHOENIX AZ
85020-2437
US

IV. Provider business mailing address

3815 E BELL RD STE 2200
PHOENIX AZ
85032-2139
US

V. Phone/Fax

Practice location:
  • Phone: 602-246-9080
  • Fax: 602-246-9105
Mailing address:
  • Phone: 602-633-3838
  • Fax: 602-633-3841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number17116
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: