Healthcare Provider Details

I. General information

NPI: 1447528575
Provider Name (Legal Business Name): KARL SIMON PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2011
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 EE BUTLER PKWY
GAINESVILLE GA
30501-4524
US

IV. Provider business mailing address

465 EE BUTLER PKWY
GAINESVILLE GA
30501-4524
US

V. Phone/Fax

Practice location:
  • Phone: 770-848-9429
  • Fax:
Mailing address:
  • Phone: 770-848-9429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH029665
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number9103405
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: