Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 19988 | OK |
N | 2080P0205X | Pediatric Endocrinologist | 19988 | OK |
NPI | 1124011150 |
---|---|
Provider Name | Dr. Edna C Solitario |
First Address | Lawton, OK 73505-6378 |
Second Address | Lawton, OK 73505-6378 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2005 |
Last Update Date | 09/07/2007 |