Healthcare Provider Details

I. General information

NPI: 1144883323
Provider Name (Legal Business Name): HADLEY ROSE POPE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2019
Last Update Date: 02/24/2023
Certification Date: 02/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SAGEBRUSH ST SW
ALBUQUERQUE NM
87105-3942
US

IV. Provider business mailing address

504 AMHERST DR NE
ALBUQUERQUE NM
87106-1310
US

V. Phone/Fax

Practice location:
  • Phone: 505-869-3200
  • Fax:
Mailing address:
  • Phone: 505-363-0842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD2022-0432
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: