Basic Information
| Provider Information | |||||||||
| NPI: | 1144294752 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOPPER | ||||||||
| FirstName: | ORLIN | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 E HAMPDEN AVE | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801132702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037617772 | ||||||||
| FaxNumber: | 7208744462 | ||||||||
| Practice Location | |||||||||
| Address1: | 10700 E GEDDES AVE | ||||||||
| Address2: | NO 200 | ||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801123800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037619190 | ||||||||
| FaxNumber: | 7208744462 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2006 | ||||||||
| LastUpdateDate: | 04/07/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 42582 | CO | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 24972 | NE | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 04-36238 | KS | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | MD17549 | HI | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 009981085 | 05 | AL | MEDICAID | 1144294752 | 05 | CT | MEDICAID | 1144294752 | 05 | IL | MEDICAID | 56708211 | 05 | CO | MEDICAID | 119960900 | 05 | WY | MEDICAID | 2934614 | 05 | OH | MEDICAID | 7617661 | 05 | NC | MEDICAID | 200425910A | 05 | OK | MEDICAID | 207362609 | 05 | MO | MEDICAID | 373593 | 05 | AZ | MEDICAID | 378824435A | 05 | GA | MEDICAID | 1144294752 | 05 | SD | MEDICAID | 62987771 | 05 | NM | MEDICAID | 99112117 | 05 | WI | MEDICAID | 1144294752 | 05 | IA | MEDICAID | 1144294752 | 05 | MO | MEDICAID | 7100098430 | 05 | KY | MEDICAID | MD584CO | 05 | AK | MEDICAID | 104693118 | 05 | MI | MEDICAID | 1144294752 | 05 | NV | MEDICAID | 1144294752 | 05 | UT | MEDICAID | 200417210A | 05 | KS | MEDICAID | 312185701 | 05 | TX | MEDICAID | 84-059792913 | 05 | NE | MEDICAID | 10025709000 | 05 | NE | MEDICAID | 1144294752 | 05 | MT | MEDICAID | 1144294752 | 05 | CA | MEDICAID |