Basic Information
| Provider Information | |||||||||
| NPI: | 1801835509 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOPP | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | BLAINE | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8901 W GAGE BLVD | ||||||||
| Address2: | |||||||||
| City: | KENNEWICK | ||||||||
| State: | WA | ||||||||
| PostalCode: | 993367148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5097351100 | ||||||||
| FaxNumber: | 5097351180 | ||||||||
| Practice Location | |||||||||
| Address1: | 8901 W GAGE BLVD | ||||||||
| Address2: | |||||||||
| City: | KENNEWICK | ||||||||
| State: | WA | ||||||||
| PostalCode: | 993367148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5097351100 | ||||||||
| FaxNumber: | 5097351180 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2006 | ||||||||
| LastUpdateDate: | 03/21/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 24575 | WA | Y | Allopathic & Osteopathic Physicians | Dermatology | 207ND0900X | 24575 | WA | N | Allopathic & Osteopathic Physicians | Dermatology | Dermatopathology | 207ND0101X | 24575 | WA | N | Allopathic & Osteopathic Physicians | Dermatology | MOHS-Micrographic Surgery | 207NI0002X | 24575 | WA | N | Allopathic & Osteopathic Physicians | Dermatology | Clinical & Laboratory Dermatological Immunology |
No ID Information.