Provider Demographics
NPI:1841382744
Name:SOLLARS, ERIC G (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:G
Last Name:SOLLARS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 N RIVERSIDE RD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-2565
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO36570174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOS735200OtherMEDICARE
MO202386215Medicaid
MO110089451OtherRAILROAD MEDICARE
MOC50911Medicare UPIN