| Michael Allen Revelle, MD | |
|
708 W Forest Ave, Jackson, TN 38301-3901 | |
| (731) 660-8759 | |
| Not Available |
| Full Name | Michael Allen Revelle |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 708 W Forest Ave, Jackson, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295714558 | NPI | - | NPPES |
| P00109858 | Other | RR MEDICARE | |
| 3861019 | Medicaid | TN | |
| 4032737 | Other | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | MD34579 (Tennessee) | Primary |
| Entity Name | Emergency Medical Care Facilities PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538345855 PECOS PAC ID: 6103837877 Enrollment ID: O20060509000565 |
| Entity Name | PA Corporate Enterprises, LLP |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518226646 PECOS PAC ID: 3971769001 Enrollment ID: O20120718000320 |
| Entity Name | J&j Health Services, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710792940 PECOS PAC ID: 5092236141 Enrollment ID: O20250306000083 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Allen Revelle, MD 1804 Highway 45 Byp, Suite 604, Jackson, TN 38305-4436 Ph: (731) 660-8759 | Michael Allen Revelle, MD 708 W Forest Ave, Jackson, TN 38301-3901 Ph: (731) 660-8759 |
John Hayes, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 708 W Forest Ave, Jackson, TN 38301 Phone: 731-660-8755 Fax: 731-660-8739 |
Dr. Donald Charles Correll, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 708 W Forest Ave, Jackson, TN 38301 Phone: 731-425-6280 Fax: 731-425-4922 |
Dr. William Tyler Hayden, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 620 Skyline Dr, Jackson, TN 38301 Phone: 731-343-0886 |
Jim C Craig Jr., M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 708 W Forest Ave, Jackson, TN 38301 Phone: 731-660-8759 |
Jay Gordon Shires, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 294 Summar Dr, Jackson, TN 38301 Phone: 731-423-1932 Fax: 731-265-8355 |
Dr. Robert D Turner, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 367 Hospital Blvd, Jackson, TN 38305 Phone: 731-661-2000 |
Shant Hagop Garabedian, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 367 Hospital Blvd, Jackson, TN 38305 Phone: 731-661-2095 |