Provider Demographics
NPI:1053558502
Name:HOPKINS, JOSHUA RHEAD (DC)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:RHEAD
Last Name:HOPKINS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 S BUCHANAN ST
Mailing Address - Street 2:PO BOX 997
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-2091
Mailing Address - Country:US
Mailing Address - Phone:618-692-6700
Mailing Address - Fax:618-692-6711
Practice Address - Street 1:435 S BUCHANAN ST
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025-2091
Practice Address - Country:US
Practice Address - Phone:618-692-6700
Practice Address - Fax:618-692-6711
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-20
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-010507111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor