Healthcare Provider Details

I. General information

NPI: 1700876570
Provider Name (Legal Business Name): JOSHUA STUART HAWLEY-MOLLOY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOSHUA STUART HAWLEY MD

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 BECKNER RD
SANTA FE NM
87507-3774
US

IV. Provider business mailing address

4200 BECKNER RD
SANTA FE NM
87507-3774
US

V. Phone/Fax

Practice location:
  • Phone: 505-477-2200
  • Fax:
Mailing address:
  • Phone: 505-477-2200
  • Fax: 505-782-1902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number21554
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberR8009
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number01053384A
License Number StateIN
# 4
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD2024-0841
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: