Wall, Holly Casey

Wall, Holly Casey is an individual health care provider with primary practice located at 8600 Fern Ave , Shreveport LA 71105-5639. She recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as her primary health care specialty. Wall, Holly Casey can be contacted via phone (318) 795-0801.

Contact Information

Primary practice address
8600 Fern Ave Shreveport LA 71105-5639
Fax: (318) 795-9492
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X L14095R Louisiana

Profile Details

NPI number 1245229624
LBN Legal business name Wall, Holly Casey
Credentials MD, FACS
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2005
Last updated Apr 9th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245229624 NPPES
Louisiana MEDICAID 1184306

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