Provider Demographics
NPI:1629076195
Name:SOLETO, ERIN ELOISE (MD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:ELOISE
Last Name:SOLETO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 FLEMING LN
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-3072
Mailing Address - Country:US
Mailing Address - Phone:318-382-9020
Mailing Address - Fax:318-382-9019
Practice Address - Street 1:608 FLEMING LN
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3072
Practice Address - Country:US
Practice Address - Phone:318-382-9020
Practice Address - Fax:318-382-9019
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2015-07-10
Deactivation Date:2006-03-15
Deactivation Code:
Reactivation Date:2006-03-20
Provider Licenses
StateLicense IDTaxonomies
LA022939174400000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA020052631OtherRAILROAD MEDICARE
LA1495697Medicaid
LA020052631OtherRAILROAD MEDICARE
LA5CC23Medicare PIN