{"npi":"1699758474","type":"NPI-1","status":"active","name":{"display":"Forrest Wall M.D.","other":[],"first":"FORREST","last":"WALL","middle":"P","credential":"M.D."},"specialty":{"primary_taxonomy":"2086S0122X","primary_taxonomy_description":"Plastic and Reconstructive Surgery Physician","slug":"plastic-and-reconstructive-surgery-physician","schema_org_specialty":null,"all":[{"code":"2086S0122X","description":"Plastic and Reconstructive Surgery Physician","primary":true,"state":"LA","license":"10089R"}]},"addresses":[{"purpose":"LOCATION","street_1":"385 BERT KOUNS INDUSTRIAL LOOP STE 100","city":"SHREVEPORT","state":"LA","postal_code":"711068159","country_code":"US","phone":"3182211629","fax":"3182216308"},{"purpose":"MAILING","street_1":"385 BERT KOUNS INDUSTRIAL LOOP BLDG 100","city":"SHREVEPORT","state":"LA","postal_code":"711068124","country_code":"US","phone":"3182211629"}],"license":{"state":"LA","number":"10089R"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20071112000574","type_code":"14-24","type_desc":"PRACTITIONER - PLASTIC AND RECONSTRUCTIVE SURGERY","state":"LA","pac_id":"3476577172"}]},"enumeration_date":"2005-11-25","last_updated":"2021-07-12","_meta":{"source":"NPPES","snapshot_date":"2021-07-12","doc_url":"https://findmynpi.com/api"}}