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Organization

REVITALIS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NATHAN JOWETT MD, PHD (DIRECTOR)
(480) 520-3223
Entity
Organization

Contact information

Practice address
7600 E CAMELBACK RD STE 7, SCOTTSDALE, AZ 85251-2106
(480) 520-3223
(480) 847-3223
Mailing address
7600 E CAMELBACK RD STE 7, SCOTTSDALE, AZ 85251-2106
(480) 520-3223
(480) 847-3223

Taxonomy

Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician

Other

Enumeration date
03/21/2025
Last updated
04/02/2026
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