Individual
JONATHAN REVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1225 N STATE ST, JACKSON, MS 39202-2064
(601) 988-5281
(601) 974-6241
Mailing address
965 RIDGE LAKE BLVD STE 315, MEMPHIS, TN 38120-9401
(877) 348-1281
(901) 227-3206
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25712
MS
390200000X
Student in an Organized Health Care Education/Training Program
T-3198
MS
Other
Enumeration date
03/20/2015
Last updated
02/03/2025
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