HOLLY CASEY WALL MD FACS NPI 1245229624

NPI Information

NPI: 1245229624
Provider Name: HOLLY CASEY WALL, MD, FACS
Classification: Surgery - 2086S0122X
Entity Type: Individual

Specialization: Plastic and Reconstructive Surgery

PECOS Registration: Yes

Address:
8600 FERN AVE
SHREVEPORT, LA
ZIP 71105
Phone: (318) 795-0801
Get Directions

Holly Casey Wall, MD, FACS is a plastic and reconstructive surgery surgery in Shreveport, LA. The provider is a surgeon who specializes in plastic and reconstructive surgery. Holly Casey Wall, MD, FACS NPI is 1245229624. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

8600 FERN AVE
SHREVEPORT, LA
ZIP 71105-639
Phone: (318) 795-0801
Fax: (318) 795-9492

The NPI 1245229624 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/18/2005 and was last updated on 4/9/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0122X	Surgery	Plastic and Reconstructive Surgery	L14095R	LOUISIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	4A495	MEDICARE ID-TYPE UNSPECIFIED
2	1184306	MEDICAID	LOUISIANA
3	H00324	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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