Simeon H. Wall, Md A Professional Medical Corp
LBN: Simeon H. Wall, Md A Professional Medical Corp
Simeon H. Wall, Md A Professional Medical Corp is an health care organization with primary practice located at 8600 Fern Ave , Shreveport LA 71105-5639. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as the primary health care specialty.
Simeon H. Wall, Md A Professional Medical Corp can be contacted via phone (318) 795-0801, or through Wall, Simeon Heninger via phone (318) 795-0801.
Contact Information
Primary practice address
8600 Fern Ave
Shreveport LA 71105-5639
Phone: (318) 795-0801
Fax: (318) 795-9492
Website:
Authorized official contact:
Name: Wall, Simeon Heninger Doctor of Medicine (MD)
Phone: (318) 795-0801
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic Surgery | 208200000X | 02970R | Louisiana |
Profile Details
| NPI number | 1992059968 |
|---|---|
| LBN Legal business name | Simeon H. Wall, Md A Professional Medical Corp |
| DBA Doing business as | |
| Authorized official | Wall, Simeon Heninger Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 30th, 2012 |
| Last updated | Oct 30th, 2012 - about 12 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992059968 | NPPES |
| Louisiana | MEDICAID | 115649 |
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