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Organization

REVELATION MEDICAL OF TULSA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES WARREN LINN (AUTHORIZED OFFICIAL)
(918) 742-4005
Entity
Organization

Contact information

Practice address
4636 S HARVARD AVE STE 104, TULSA, OK 74135-2908
(918) 742-4005
Mailing address
4636 S HARVARD AVE STE 104, TULSA, OK 74135-2908
(918) 742-4005

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
207Q00000X
Family Medicine Physician
225100000X
Physical Therapist

Other

Enumeration date
01/24/2022
Last updated
10/03/2023
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