Provider Demographics
NPI:1699710830
Name:DAVID W WALL & HARRIS A LAPPIN PTR
Entity type:Organization
Organization Name:DAVID W WALL & HARRIS A LAPPIN PTR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:EDWARDS
Authorized Official - Last Name:LEBLANC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-757-2409
Mailing Address - Street 1:7777 HENNESSY BLVD
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4300
Mailing Address - Country:US
Mailing Address - Phone:225-767-3900
Mailing Address - Fax:225-214-9109
Practice Address - Street 1:7777 HENNESSY BLVD
Practice Address - Street 2:SUITE 1000
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4300
Practice Address - Country:US
Practice Address - Phone:225-767-3900
Practice Address - Fax:225-214-9109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA09558OtherBCBS
LACQ2050OtherPALMETTO GBA 10066
LA1173711Medicaid
LA1173711Medicaid
LA5C921Medicare ID - Type Unspecified