Provider Demographics
NPI:1306040472
Name:HARRIS, KATHERINE IRENE (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:IRENE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:IRENE
Other - Last Name:GIMBEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1007
Mailing Address - Country:US
Mailing Address - Phone:319-356-4241
Mailing Address - Fax:319-356-3086
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242
Practice Address - Country:US
Practice Address - Phone:319-356-4241
Practice Address - Fax:319-356-3086
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN50845207R00000X
IA38832207R00000X
IAMD-38832208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN110012061Medicare PIN