Mortimore, Robert Harry

Mortimore, Robert Harry is an individual health care provider with primary practice located at 1900 N Dewey Ave , Reedsburg WI 53959-2214. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Mortimore, Robert Harry can be contacted via phone (608) 524-6477.

Contact Information

Primary practice address
1900 N Dewey Ave Reedsburg WI 53959-2214
Phone: (608) 524-6477
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 20757 Wisconsin

Profile Details

NPI number 1760479471
LBN Legal business name Mortimore, Robert Harry
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2005
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760479471 NPPES
Wisconsin MEDICAID 30107100

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