Provider Demographics
NPI:1205013216
Name:ROBERT C HARRIS MD PA
Entity Type:Organization
Organization Name:ROBERT C HARRIS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-747-4631
Mailing Address - Street 1:3820 E 51ST ST
Mailing Address - Street 2:STE B
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-3627
Mailing Address - Country:US
Mailing Address - Phone:918-747-4631
Mailing Address - Fax:
Practice Address - Street 1:3820 E 51ST ST
Practice Address - Street 2:STE B
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-3627
Practice Address - Country:US
Practice Address - Phone:918-747-4631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty