Individual
VIRGINIA REVILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1586 DEPAUL RD, NEWPORT, TN 37821-6280
(678) 793-5448
Mailing address
1586 DEPAUL RD, NEWPORT, TN 37821-6280
(678) 793-5448
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27359
TN
Other
Enumeration date
04/05/2020
Last updated
11/01/2023
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