Provider Demographics
NPI:1124011150
Name:SOLITARIO, EDNA C (MD)
Entity Type:Individual
Prefix:DR
First Name:EDNA
Middle Name:C
Last Name:SOLITARIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3201 W GORE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-6378
Mailing Address - Country:US
Mailing Address - Phone:580-353-8942
Mailing Address - Fax:580-353-5008
Practice Address - Street 1:3201 W GORE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-6378
Practice Address - Country:US
Practice Address - Phone:580-353-8942
Practice Address - Fax:580-353-5008
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK19988208000000X, 2080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology