MEDICARE: MARCUS HOPKINS

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	106S00000X	Behavior Technician	RBT-24-332253	TX

General Provider Information

NPI Number	:	1700740651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCUS HOPKINS

Provider Business Mailing Address
First Line	:	13624 S 21ST PL E
Second Line	:
City	:	BIXBY
State	:	OK
Zip	:	74008-2192
Country	:	US
Telephone Number	:	832-571-9953
Fax Number	:

Provider Business Practice Location Address
First Line	:	721 W QUEENS ST
Second Line	:
City	:	BROKEN ARROW
State	:	OK
Zip	:	74012-1767
Country	:	US
Telephone Number	:	539-367-1534
Fax Number	:

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

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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