MEDICARE: JOSEPH PERRY POPE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	94-359	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	23819	OTHER	NJ	PRESBYTERIAN SALUD
2	3861	OTHER	NM	LOVELACE
3	NM003000	OTHER	NM	BLUE CROSS/BLUE SHIELD
4	002	OTHER	NM	CIMMARON SALUD
5	23819	OTHER	NM	PRESBYTERIAN
6	3861	OTHER	NM	LOVELACE SALUD
7	002	OTHER	NM	CIMMARON
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689677791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH PERRY POPE M.D.

Provider Business Mailing Address
First Line	:	2300 E 30TH ST
Second Line	:	BLDG B
City	:	FARMINGTON
State	:	NM
Zip	:	87401-8990
Country	:	US
Telephone Number	:	505-324-1000
Fax Number	:	505-324-1199

Provider Business Practice Location Address
First Line	:	2300 E 30TH ST
Second Line	:	BLDG B
City	:	FARMINGTON
State	:	NM
Zip	:	87401-8990
Country	:	US
Telephone Number	:	505-324-1000
Fax Number	:	505-324-1199

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	04/20/2008

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Directions to “ JOSEPH PERRY POPE M.D.” Practice Location

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