Provider Demographics
NPI:1245786524
Name:SOLOMON, STRATTON (OD)
Entity Type:Individual
Prefix:DR
First Name:STRATTON
Middle Name:
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 E IOWA ST
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:AZ
Mailing Address - Zip Code:86025-2770
Mailing Address - Country:US
Mailing Address - Phone:928-524-6171
Mailing Address - Fax:928-524-3963
Practice Address - Street 1:421 E IOWA ST
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:AZ
Practice Address - Zip Code:86025-2770
Practice Address - Country:US
Practice Address - Phone:928-524-6171
Practice Address - Fax:928-524-3963
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2143152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist