Healthcare Provider Details

I. General information

NPI: 1710023312
Provider Name (Legal Business Name): SUSAN COTTRELL HOPKINS LICENSED ACUPUNCTURI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUSAN C HOPKINS LICENSED ACUPUNCTURI

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2160 WESTWOOD LANE
EUGENE OR
97401
US

IV. Provider business mailing address

2160 WESTWOOD LANE
EUGENE OR
97401
US

V. Phone/Fax

Practice location:
  • Phone: 541-484-4064
  • Fax:
Mailing address:
  • Phone: 541-484-4064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number008925
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: