Provider Demographics
NPI:1447528575
Name:SIMON, KARL (PHARMD)
Entity type:Individual
Prefix:
First Name:KARL
Middle Name:
Last Name:SIMON
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 1:5400 INDEPENDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64123-2027
Mailing Address - Country:US
Mailing Address - Phone:816-231-0730
Mailing Address - Fax:
Practice Address - Street 1:2027 LAWRENCEVILLE SUWANEE RD STE 700
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-2658
Practice Address - Country:US
Practice Address - Phone:678-878-2082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-04
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH029665183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist