Healthcare Provider Details

I. General information

NPI: 1497137905
Provider Name (Legal Business Name): SOLORAD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2015
Last Update Date: 02/19/2021
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3260 HOSPITAL DR
JUNEAU AK
99801-7808
US

IV. Provider business mailing address

PO BOX 35726
JUNEAU AK
99803-5726
US

V. Phone/Fax

Practice location:
  • Phone: 907-321-0885
  • Fax:
Mailing address:
  • Phone: 907-313-5806
  • Fax: 907-500-7362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number1022879
License Number StateAK

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierMEDO4600
Identifier TypeOTHER
Identifier StateAK
Identifier IssuerMEDICAL LICENSE

VIII. Authorized Official

Name: DR. STEVEN T STRICKLER
Title or Position: OWNER
Credential: D.O.
Phone: 907-313-5806