IndividualActive
Simeon Wall, MD, FACS
NPI 1275522682 · Plastic and Reconstructive Surgery Physician · Shreveport, LA
Provider details
- NPI number
- 1275522682
- Entity type
- Individual
- Primary specialty
- Plastic and Reconstructive Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD, FACS
- Sex
- Male
- Sole proprietor
- No
- License
- 14159R (LA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
8600 Fern Ave
Shreveport, LA 71105-5639
Phone: (318) 795-0801
Fax: (318) 795-9492
Approximate (ZIP-level) locationGet directions
Mailing address
8600 Fern Ave
Shreveport, LA 71105-5639
Registry dates
- Enumerated
- 2005-10-18
- Last updated
- 2014-04-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.