MEDICARE: JOHN SOLAK MD, MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083X0100X	Occupational Medicine Physician	22077	HI
2	2083A0100X	Aerospace Medicine Physician	22077	HI

General Provider Information

NPI Number	:	1770107989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN SOLAK MD, MPH

Provider Business Mailing Address
First Line	:	1650 COCHRANE CIR UNIT MEDDAC
Second Line	:
City	:	FORT CARSON
State	:	CO
Zip	:	80913-4604
Country	:	US
Telephone Number	:	719-526-1910
Fax Number	:

Provider Business Practice Location Address
First Line	:	3524 AIRFIELD RD
Second Line	:
City	:	FT CARSON
State	:	CO
Zip	:	80913-4701
Country	:	US
Telephone Number	:	719-526-1910
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2020
Last Update Date	:	09/20/2024

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