Walter J Revell Jr. (NPI# 1275641995, PAC ID# 6800883489) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1275641995 |
| PAC ID by PECOS | 6800883489 |
| Professional Enrollment ID | I20180820000953 |
| Full Name | Walter J Revell Jr. |
| Organization Legal Name | PETERSON DERMATOLOGY, P.C. |
| Address |
305 1st St W Vidalia GA 30474 |
| Phone Number | 9125389080 |
| Gender | M |
| Medical School | MEDICAL COLLEGE OF GEORGIA |
| Graduation Year | 1974 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 7113018334 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 305 1st St W, Vidalia, GA 30474 | 9125389080 | PETERSON DERMATOLOGY, P.C. |
| Organization Legal Name | PETERSON DERMATOLOGY, P.C. |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Karen Pamela Mcneely | Nurse Practitioner | Peterson Dermatology, P.C. | 305 1st St W, Vidalia, GA 30474 |
| Letty Revell Peterson | Dermatology | Peterson Dermatology, P.C. | 305 1st St W, Vidalia, GA 30474 |
| Street Address |
305 1ST ST W |
| City | VIDALIA |
| State | GA |
| Zip | 30474 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Karen Pamela Mcneely | Nurse Practitioner | Peterson Dermatology, P.C. | 305 1st St W, Vidalia, GA 30474 |
| Letty Revell Peterson | Dermatology | Peterson Dermatology, P.C. | 305 1st St W, Vidalia, GA 30474 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John Casey Spivey | Orthopedic Surgery | Mark Spivey Orthopedic Clinic LLC | 3301 1st St E, Suite A, Vidalia, GA 30474 |
| David H Paine | Internal Medicine | 1006 A Mt Vernon Rd, Vidalia, GA 30474 | |
| Archie J Champion | Physician Assistant | Mark Spivey Orthopedic Clinic LLC | 3301 1st St E, Suite A, Vidalia, GA 30474 |
| Charles M Spivey | Orthopedic Surgery | Mark Spivey Orthopedic Clinic LLC | 3301 1st St E, Suite A, Vidalia, GA 30474 |
| Richard M Proenza | Physician Assistant | Mark Spivey Orthopedic Clinic LLC | 3301 1st St E, Suite A, Vidalia, GA 30474 |
| Paul J Giles | Cardiovascular Disease (cardiology) | Paul Joseph Giles Md LLC | 1006 Mount Vernon Rd, Vidalia, GA 30474-3029 |
| Robert Andrew Bell | Nurse Practitioner | Paul Joseph Giles Md LLC | 1006 Mount Vernon Rd, Vidalia, GA 30474-3029 |
| Jeanie L Allen | Nurse Practitioner | Paul Joseph Giles Md LLC | 1006 Mount Vernon Rd, Vidalia, GA 30474-3029 |
| Terra Hardeman | Nurse Practitioner | Paul Joseph Giles Md LLC | 1006 Mount Vernon Rd, Vidalia, GA 30474-3029 |
| Ramachand R Paidi | Neuropsychiatry | 106 Queen St, 1a, Vidalia, GA 30474-4210 | |
| Find all physicians in zip 30474 | |||
| City | VIDALIA |
| Zip Code | 30474 |
| Specialty | GENERAL SURGERY |
| City + Specialty | VIDALIA + GENERAL SURGERY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.