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1700939147
SIMEON H. WALL
SHREVEPORT, LA
NPI
1700939147
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: LA 02970R)
Enumeration Date
2007-01-19
Last Update Date
2012-02-22
Business Address
Dr. SIMEON H. WALL M.D.
8600 FERN AVE
SHREVEPORT, LA 71105-5639
Phone number: 318-795-0801
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Mailing Address
Dr. SIMEON H. WALL M.D.
8600 FERN AVE
SHREVEPORT, LA 71105-5639
Phone number: 318-795-0801
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