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General NPI Number Information
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NPI Number | 1992178164
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Entity Type | Individual
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Provider Name | ROBERT HARRIS HIS
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Gender | Male
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Dates
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Enumeration Date | 11/10/2015
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Last Update Date | 11/10/2015
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Provider Practice Location Address
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Address Line | 108 YELLOW CREEK RD
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City | EVANSTON
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State | WY
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Zip | 82930-5234
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Country | US
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Telephone | 435-740-0860
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Fax |
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Provider Business Mailing Address
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Address Line | 108 YELLOW CREEK RD
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City | EVANSTON
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State | WY
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Zip | 82930-5234
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Country | US
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Telephone | 435-740-0860
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Fax |
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 193
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 9171940-4602
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HA-2805
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License Number State | ID
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