Provider Demographics
NPI:1225016348
Name:SOLOMON, JOEL P (CRNA)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:P
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43086-0280
Mailing Address - Country:US
Mailing Address - Phone:614-523-2211
Mailing Address - Fax:614-523-2288
Practice Address - Street 1:1275 N HIGH ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-8273
Practice Address - Country:US
Practice Address - Phone:614-523-2211
Practice Address - Fax:614-523-2288
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN150776367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPENDINGMedicaid
OHPENDINGMedicaid