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General NPI Number Information
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NPI Number | 1740313675
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Entity Type | Individual
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Provider Name | ROBERT H HARALSON III MD
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Gender | Male
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6300 N RIVER RD
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City | ROSEMONT
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State | IL
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Zip | 60018-4206
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Country | US
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Telephone | 846-384-4040
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Fax | 847-823-8028
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Provider Business Mailing Address
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Address Line | 6300 N RIVER RD
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City | ROSEMONT
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State | IL
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Zip | 60018-4206
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Country | US
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Telephone | 846-384-4040
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Fax | 847-823-8028
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD0000005090
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License Number State | TN
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