DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. WENDELL E. WALL, M.D.

Active Sole Proprietor

Internal Medicine · SHREVEPORT, LA

Registration Details

NPI Number
1639174105
Provider Type
Individual
Gender
Male
NPI Issued
Jun 20, 2005 (20.835850968185 yrs)
Last Updated
Oct 22, 2018
Licenses
11458R (LA)
MD.11458R (LA)
Sole Proprietor
Yes

Practice Information

Address
1801 FAIRFIELD AVENUE, SUITE 200
SHREVEPORT, LA, 71101
Browse LA providers · Browse ZIP 71101
Phone
3186751800
Fax
3186751818
Primary Specialty
Internal Medicine
207R00000X
Additional Specialty
Internal Medicine

Other Internal Medicine Providers in SHREVEPORT, LA

Name Credential NPI
PAUL A RUSHING MD 1003810904
DR. ROAN L FLENNIKEN MD 1023012960
DR. RICHARD JAMES MICHAEL MD 1861496671
ALAN JOHN BORNE M.D. 1700881299
DR. PEYMAN ROOHANI MD 1285632745
DR. THOMAS STEEN TRAWICK JR. M.D. 1487652970
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.