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1275522682
SIMEON WALL
SHREVEPORT, LA
NPI
1275522682
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2086S0122X Surgery, Plastic and Reconstructive Surgery
(Licence: LA 14159R)
Enumeration Date
2005-10-18
Last Update Date
2014-04-10
Business Address
-- SIMEON WALL MD, FACS
8600 FERN AVE
SHREVEPORT, LA 71105-5639
Phone number: 318-795-0801
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Mailing Address
-- SIMEON WALL MD, FACS
8600 FERN AVE
SHREVEPORT, LA 71105-5639
Phone number: 318-795-0801
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