Provider Demographics
NPI:1245544535
Name:HARRIS, ROBERT R (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:R
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BELOIT HEALTH SYSTEM INC
Mailing Address - Street 2:1969 W HART ROAD
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-2230
Mailing Address - Country:US
Mailing Address - Phone:608-364-2293
Mailing Address - Fax:608-364-5525
Practice Address - Street 1:BELOIT CLINIC
Practice Address - Street 2:1905 E HUEBBE PARKWAY
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-1842
Practice Address - Country:US
Practice Address - Phone:608-364-2220
Practice Address - Fax:608-363-7306
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01077170A207V00000X
WV27973207V00000X
WI83271-20207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1245544535Medicaid
MI4301112554OtherMI LICENSE
WI100265463Medicaid