Healthcare Provider Details

I. General information

NPI: 1194834465
Provider Name (Legal Business Name): JOSHUA JAMES HOPKINS O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 06/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 W 7TH ST
WAYNE NE
68787-1683
US

IV. Provider business mailing address

PO BOX 309
WAYNE NE
68787-0309
US

V. Phone/Fax

Practice location:
  • Phone: 402-375-5160
  • Fax: 402-375-3302
Mailing address:
  • Phone: 402-375-5160
  • Fax: 402-375-3302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1169
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: