Healthcare Provider Details

I. General information

NPI: 1093655714
Provider Name (Legal Business Name): MARY GAYNELL HOPKINS PRC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1044 W BRISTOL RD
FLINT MI
48507-5516
US

IV. Provider business mailing address

1044 W BRISTOL RD
FLINT MI
48507-5516
US

V. Phone/Fax

Practice location:
  • Phone: 810-238-0483
  • Fax: 810-238-5519
Mailing address:
  • Phone: 810-238-0483
  • Fax: 810-238-5519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: