Provider Demographics
NPI:1316945462
Name:GEOFFROY, RONALD A II (PD)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:A
Last Name:GEOFFROY
Suffix:II
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:799 WORTHY ST
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563-1360
Mailing Address - Country:US
Mailing Address - Phone:337-364-4910
Mailing Address - Fax:337-364-0465
Practice Address - Street 1:805 CENTER ST
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-5505
Practice Address - Country:US
Practice Address - Phone:337-364-0464
Practice Address - Fax:337-264-0465
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9248183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist