Revill, Jeffrey J

Revill, Jeffrey J is an individual health care provider with primary practice located at 1530 Center Star Rd , Columbia TN 38401. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Revill, Jeffrey J can be contacted via phone (931) 626-0117.

Contact Information

Primary practice address
1530 Center Star Rd Columbia TN 38401
Fax: (931) 380-3640
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 37837 Tennessee
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35.098156 Ohio

Profile Details

NPI number 1679567523
LBN Legal business name Revill, Jeffrey J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2005
Last updated Jun 19th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679567523 NPPES
Ohio MEDICAID 0056324
Ohio MEDICAID 3897284

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