MEDICARE: DR. DEANNA LYNN HOPSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	C 7493	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	54231	OTHER	AR	PART B BCBS INDIV PROV NO

General Provider Information

NPI Number	:	1548329857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEANNA LYNN HOPSON M.D.

Provider Business Mailing Address
First Line	:	600 S. TIMBERLANE DRIVE
Second Line	:
City	:	EL DORADO
State	:	AR
Zip	:	71730-4519
Country	:	US
Telephone Number	:	870-862-2400
Fax Number	:	870-862-1891

Provider Business Practice Location Address
First Line	:	600 S TIMBERLANE DRIVE
Second Line	:
City	:	EL DORADO
State	:	AR
Zip	:	71730-4519
Country	:	US
Telephone Number	:	870-862-2400
Fax Number	:	870-862-1891

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	07/27/2016

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