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General NPI Number Information
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NPI Number | 1851846653
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Entity Type | Individual
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Provider Name | TYLER MARIE KILES PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/22/2016
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Last Update Date | 08/22/2016
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Provider Practice Location Address
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Address Line | 2345 PEACHTREE RD NE
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City | ATLANTA
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State | GA
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Zip | 30305-4147
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Country | US
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Telephone | 404-233-2101
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Fax |
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Provider Business Mailing Address
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Address Line | 305 BROOKHAVEN AVE NE APT 736
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City | BROOKHAVEN
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State | GA
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Zip | 30319-3253
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Country | US
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Telephone | 817-209-4609
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH029415
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 59195
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License Number State | TX
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