Organization

Revelation Medical Of Tulsa Llc

Pain Medicine (Anesthesiology) Physician in Tulsa, OK(View on Map)

Legal Business Name

Revelation Medical Of Tulsa Llc

NPI Number

1366194110

NPI Type

Organization

Enumeration Date

01/24/2022

Specialties

(Taxonomies)

Code

207LP2900X
207Q00000X
225100000X

Primary Taxonomy

Yes
No
No

Contact
Information

Purpose

Mailing
Location

Address

4636 S HARVARD AVE STE 104
4636 S HARVARD AVE STE 104

City

Tulsa
Tulsa

State

OK
OK

Postal Code

74135-2908
74135-2908

Country

US
US

Telephone Number

(918) 742-4005
(918) 742-4005

Authorized Official

Name

James Linn

Title or Position

AUTHORIZED OFFICIAL

Telephone Number

(918) 742-4005

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 10/03/2023

Provider Address

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