Individual
ROBERT BOATWRIGHT HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
124 COMMODORE ST STE B, PRATT, KS 67124-2995
(620) 672-6454
(620) 672-3488
Mailing address
200 COMMODORE ST, PRATT, KS 67124-2903
(620) 450-1186
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
00019179
AL
208600000X
Surgery Physician
Primary
04-43413
KS
208600000X
Surgery Physician
12574
MS
2086S0105X
Surgery of the Hand (Surgery) Physician
12574
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000033694
—
AL
05
—
00110609
—
MS
01
—
051033694
BC/BS OF AL
AL
Enumeration date
10/24/2006
Last updated
03/26/2021
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