Basic Information
| Provider Information | |||||||||
| NPI: | 1245786524 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOLOMON | ||||||||
| FirstName: | STRATTON | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 421 E IOWA ST | ||||||||
| Address2: | |||||||||
| City: | HOLBROOK | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 860252770 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9285246171 | ||||||||
| FaxNumber: | 9285243963 | ||||||||
| Practice Location | |||||||||
| Address1: | 421 E IOWA ST | ||||||||
| Address2: | |||||||||
| City: | HOLBROOK | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 860252770 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9285246171 | ||||||||
| FaxNumber: | 9285243963 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2016 | ||||||||
| LastUpdateDate: | 04/30/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 2143 | AZ | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.