Healthcare Provider Details

I. General information

NPI: 1306816913
Provider Name (Legal Business Name): DR. JUDITH O HOPKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 KERNERSVILLE MEDICAL PKWY STE 116
KERNERSVILLE NC
27284-7156
US

IV. Provider business mailing address

PO BOX 75216
CHARLOTTE NC
28275-0216
US

V. Phone/Fax

Practice location:
  • Phone: 336-564-4170
  • Fax: 336-564-4936
Mailing address:
  • Phone: 336-993-6663
  • Fax: 336-993-7183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number23565
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number23565
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: