Provider Demographics
NPI:1598887408
Name:ERIC G SOLLARS, MD
Entity Type:Organization
Organization Name:ERIC G SOLLARS, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-271-1370
Mailing Address - Street 1:802 N RIVERSIDE RD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-9794
Mailing Address - Country:US
Mailing Address - Phone:816-271-1370
Mailing Address - Fax:816-271-1371
Practice Address - Street 1:802 N RIVERSIDE RD
Practice Address - Street 2:SUITE 330
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64507-9794
Practice Address - Country:US
Practice Address - Phone:816-271-1370
Practice Address - Fax:816-271-1371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO36570174400000X
MO2002030219174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO36570OtherLICENSE
MOS730000Medicare ID - Type Unspecified
MOC50911Medicare UPIN