Wall, Simeon
Wall, Simeon is an individual health care provider with primary practice located at 8600 Fern Ave , Shreveport LA 71105-5639. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Wall, Simeon can be contacted 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:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery | 2086S0122X | 14159R | Louisiana |
Profile Details
| NPI number | 1275522682 |
|---|---|
| LBN Legal business name | Wall, Simeon |
| Credentials | MD, FACS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 18th, 2005 |
| Last updated | Apr 10th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275522682 | NPPES |
| Louisiana | MEDICAID | 1184292 |
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