Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Simeon H. Wall, MD a Professional Medical Corp

Organization Plastic Surgery Physician · NPI 1992059968

Simeon H. Wall, MD a Professional Medical Corp is a Plastic Surgery Physician in Shreveport, Louisiana. Licensed in Louisiana. Registered with an NPI since 2012.

Licensed in
LA
In the registry since
2012
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

8600 Fern Ave
Shreveport, LA 71105-5639
Phone: (318) 795-0801
Fax: (318) 795-9492
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X · Licence 02970R (LA)

Record details

NPI number1992059968
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Simeon Wall — Owner · (318) 795-0801
NPI enumeratedOctober 30, 2012
Last updated in NPPESOctober 30, 2012
Mailing address8600 Fern Ave, Shreveport, LA 71105-5639

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