Revell, Robert
Revell, Robert is an individual health care provider with primary practice located at 1600 Broad Ave , Gulfport MS 39501-3603. He recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as his primary health care specialty. Revell, Robert can be contacted via phone (228) 865-1719.Contact Information
Primary practice address
1600 Broad Ave
Gulfport MS 39501-3603
Phone: (228) 865-1719
Fax: (228) 865-1780
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Peer Specialist | 175T00000X | 390 | Mississippi |
Profile Details
| NPI number | 1073077418 |
|---|---|
| LBN Legal business name | Revell, Robert |
| Credentials | CPSS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 30th, 2019 |
| Last updated | Jul 12th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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