Provider Demographics
NPI:1972887735
Name:SIMONEAUX, KILEY JAMES (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:KILEY
Middle Name:JAMES
Last Name:SIMONEAUX
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6576 JONES CREEK RD STE B
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-3023
Mailing Address - Country:US
Mailing Address - Phone:225-214-0133
Mailing Address - Fax:225-214-0136
Practice Address - Street 1:6576 JONES CREEK RD STE B
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817-3023
Practice Address - Country:US
Practice Address - Phone:225-214-0133
Practice Address - Fax:225-214-0136
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017785183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist