Provider Demographics
NPI:1669568960
Name:HOPKINS, DAVID CANTER (PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CANTER
Last Name:HOPKINS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1372 LINDENWOOD GRV
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-7605
Mailing Address - Country:US
Mailing Address - Phone:719-314-7773
Mailing Address - Fax:719-636-8989
Practice Address - Street 1:916 N WEBER ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2921
Practice Address - Country:US
Practice Address - Phone:719-314-7773
Practice Address - Fax:719-636-8989
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO2290103TR0400X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO633067OtherBLUE CROSS BLUE SHIELD
CO30755557Medicaid
CO126599OtherCOL HEALTH NETWORK/VALUE
CO126599OtherCOL HEALTH NETWORK/VALUE
CO69976Medicare ID - Type Unspecified