| Revelation Medical Of Tulsa Llc | |
|
4636 S Harvard Ave Ste 104 Tulsa OK 74135-2908 | |
| (918) 742-4005 | |
| Not Available |
| Full Name | Revelation Medical Of Tulsa Llc |
|---|---|
| Speciality | Anesthesiology |
| Location | 4636 S Harvard Ave Ste 104, Tulsa, Oklahoma |
| Authorized Official Name and Position | James Warren Linn (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 9187424005 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revelation Medical Of Tulsa Llc 4636 S Harvard Ave Ste 104 Tulsa OK 74135-2908 Ph: (918) 742-4005 | Revelation Medical Of Tulsa Llc 4636 S Harvard Ave Ste 104 Tulsa OK 74135-2908 Ph: (918) 742-4005 |
| NPI Number | 1366194110 |
|---|---|
| Provider Enumeration Date | 01/24/2022 |
| Last Update Date | 10/03/2023 |
| Medicare PECOS PAC ID | 5294122933 |
|---|---|
| Medicare Enrollment ID | O20220427000588 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366194110 | NPI | - | NPPES |
| Provider Name | Ladd C Atkins |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1912198375 PECOS PAC ID: 8729174842 Enrollment ID: I20071019000333 |
| Provider Name | Brian Thomas Torgerson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1194928283 PECOS PAC ID: 6103009543 Enrollment ID: I20110725000448 |
| Provider Name | Jennifer L Curran Blair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982956462 PECOS PAC ID: 2163673799 Enrollment ID: I20121108000158 |
| Provider Name | Jennifer A Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700125986 PECOS PAC ID: 7911143987 Enrollment ID: I20130417000320 |
| Provider Name | Adam Joseph Wallace |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1518129733 PECOS PAC ID: 5193972750 Enrollment ID: I20130820000231 |
| Provider Name | John P Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255746962 PECOS PAC ID: 2062632961 Enrollment ID: I20140926001748 |
| Provider Name | Kristin Tidwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396418679 PECOS PAC ID: 6103221239 Enrollment ID: I20210826003373 |
| Provider Name | Shane Foster |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528708344 PECOS PAC ID: 0547657298 Enrollment ID: I20220427000682 |
| Provider Name | Jaimie Peter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790489847 PECOS PAC ID: 0345607636 Enrollment ID: I20230531003357 |
Tulsa Internal Medicine Physicians, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2000 S Wheeling Ave, Ste 1000, Tulsa, OK 74104 Phone: 918-748-8467 | |
Susan C. Willard, Do, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6532 E. 71st Street, Suite 150, Tulsa, OK 74133 Phone: 918-740-4630 Fax: 918-289-0091 | |
Gamble Family Medical Practice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4134 S Harvard Ave Ste B3, Tulsa, OK 74135 Phone: 918-442-2236 Fax: 918-794-2333 | |
Community Health Connection, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 13702 E 46th Pl, Tulsa, OK 74134 Phone: 918-622-0641 Fax: 918-622-4814 | |
Qt Quikmed Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4705 S 129th East Ave, Tulsa, OK 74134 Phone: 918-994-3953 | |
Shepcole, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1532 S Peoria Ave, Tulsa, OK 74120 Phone: 918-609-5600 | |
Careatc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 808 N 161st East Ave, Tulsa, OK 74116 Phone: 800-993-8244 |