Provider Demographics
NPI:1861570905
Name:HOPKINS, TOBY JACK (DC)
Entity type:Individual
Prefix:
First Name:TOBY
Middle Name:JACK
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 1:102 MEMORIAL DR # A
Mailing Address - Street 2:
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30533-0801
Mailing Address - Country:US
Mailing Address - Phone:706-867-7015
Mailing Address - Fax:
Practice Address - Street 1:102 MEMORIAL DR # A
Practice Address - Street 2:
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533-0801
Practice Address - Country:US
Practice Address - Phone:706-867-7015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006533111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00912931AMedicaid
GA35ZCFSXMedicare ID - Type Unspecified