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SIMEON H. WALL, MD A PROFESSIONAL MEDICAL CORP
NPI 1992059968
Plastic Surgery in Shreveport, LA

Active since October 30, 2012
8600 FERN AVE, SHREVEPORT, LA 71105(318) 795-0801(318) 795-9492 Get Directions Write a Review

NPPES record last updated: October 30, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Simeon H. Wall, Md A Professional Medical Corp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SIMEON H. WALL, MD A PROFESSIONAL MEDICAL CORP (NPI 1992059968) is a healthcare organization registered as a plastic surgery in Shreveport, Louisiana and active in the NPI registry since October 2012. The organization lists Simeon Heninger Wall, Owner, as its authorized official.

NPPES Registry Identity

NPI1992059968
Entity TypeOrganization
Primary Taxonomy208200000X
Legal Business NameSIMEON H. WALL, MD A PROFESSIONAL MEDICAL CORP
Location Address8600 FERN AVEShreveport, LA 71105-5639
Mailing Address8600 Fern AveShreveport, LA 71105-5639 · (318) 795-0801 · Fax (318) 795-9492
Phone(318) 795-0801
Fax(318) 795-9492
Organization SubpartNo
Authorized OfficialSimeon Heninger WallOwner · (318) 795-0801
Enumeration DateOctober 30, 2012
✔ NPI 1992059968 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
License✔ Licensed in LA · 02970R
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
8600 FERN AVE, Shreveport, LA 71105
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Other Identifiers 3

Medicare UPINB61438LA
Medicare PIN5L694LA
Medicaid115649LA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HOLLY CASEY WALL MD, FACS
Surgery (Plastic and Reconstructive Surgery)
8600 FERN AVE
SHREVEPORT, LA 71105
Caddo Parish (318) 795-0801
SIMEON WALL JR. MD, FACS
Surgery (Plastic and Reconstructive Surgery)
8600 FERN AVE
SHREVEPORT, LA 71105
Caddo Parish (318) 795-0801
DR. SIMEON H. WALL SR. M.D.
Specialist
8600 FERN AVE
SHREVEPORT, LA 71105
Caddo Parish (318) 795-0801
MRS. JEANNIE SHIM MCALLISTER PA-C
Physician Assistant (Medical)
8600 FERN AVE
SHREVEPORT, LA 71105
Caddo Parish (318) 213-1772

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Simeon H. Wall, MD A Professional Medical Corp's NPI number?

The NPI number for Simeon H. Wall, MD A Professional Medical Corp is 1992059968. It was assigned to this organization in the NPPES registry on October 30, 2012.

Where is Simeon H. Wall, MD A Professional Medical Corp located?

Simeon H. Wall, MD A Professional Medical Corp is located at 8600 Fern Ave, Shreveport, LA 71105. The listed phone number is (318) 795-0801.

What is Simeon H. Wall, MD A Professional Medical Corp's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

When was this NPI record last updated?

The NPPES record for Simeon H. Wall, MD A Professional Medical Corp was last updated on October 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.