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Individual

MR. JEFFREY J REVILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1530 CENTER STAR RD, COLUMBIA, TN 38401
(931) 626-0117
(931) 380-3640
Mailing address
1530 CENTER STAR ROAD, COLUMBIA, TN 38401
(931) 626-0117
(931) 380-3640

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
37837
TN
207Q00000X
Family Medicine Physician
35.098156
OH
207Q00000X
Family Medicine Physician
Primary
C3932
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0056324
OH
05
3897284
TN
Enumeration date
09/07/2005
Last updated
12/23/2025
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