| Revelation Medical Llc | |
|
4636 S Harvard Ave Ste 104 Tulsa OK 74135-2908 | |
| (918) 398-8900 | |
| Not Available |
| Full Name | Revelation Medical Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 4636 S Harvard Ave Ste 104, Tulsa, Oklahoma |
| Authorized Official Name and Position | James Linn (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 9183988900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revelation Medical Llc 4636 S Harvard Ave Ste 104 Tulsa OK 74135-2908 Ph: (918) 398-8900 | Revelation Medical Llc 4636 S Harvard Ave Ste 104 Tulsa OK 74135-2908 Ph: (918) 398-8900 |
| NPI Number | 1710640255 |
|---|---|
| Provider Enumeration Date | 10/21/2021 |
| Last Update Date | 10/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710640255 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
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