Provider Demographics
NPI:1174532089
Name:HOPEY, PAUL CHARLES (PA)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:CHARLES
Last Name:HOPEY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:390 KEOWEE SCHOOL RD
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29672-6743
Practice Address - Country:US
Practice Address - Phone:864-885-7129
Practice Address - Fax:864-882-7240
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004830363A00000X
SC998363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA449339956AMedicaid
SCAA24388768OtherMEDICARE PTAN
SCGP4697Medicaid
SC0832PAMedicaid
GA449339956BMedicaid
SCGP4697Medicaid
SC0832PAMedicare UPIN
GA449339956AMedicaid
SC0832PAMedicaid