Provider Demographics
NPI:1730437153
Name:SOILEAU, GUY L (RPH)
Entity type:Individual
Prefix:
First Name:GUY
Middle Name:L
Last Name:SOILEAU
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 DUFFY LN
Mailing Address - Street 2:
Mailing Address - City:VILLE PLATTE
Mailing Address - State:LA
Mailing Address - Zip Code:70586-6000
Mailing Address - Country:US
Mailing Address - Phone:337-363-6990
Mailing Address - Fax:
Practice Address - Street 1:137 DUFFY LN
Practice Address - Street 2:
Practice Address - City:VILLE PLATTE
Practice Address - State:LA
Practice Address - Zip Code:70586-6000
Practice Address - Country:US
Practice Address - Phone:337-363-6990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11258183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist