| Doctor Name: | MICHAEL ALLEN REVELLE |
| NPI Number: | 1295714558 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | MD34579 |
| Business Practice Address: | 708 W Forest Ave Jackson, TN - 383013901 |
| Business Phone Number: | 7316608759 |
| Business Fax Number: | |
| Mailing Address: | 1804 Highway 45 Byp, Suite 604 JACKSON |
| State: | TN |
| Postal Code: | 383054436 |
| Phone Number: | 7316608759 |
| Fax Number: | |
| NPI Enumeration Date: | 01/13/2006 |
| NPI Last Update Date: | 07/16/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207P00000X |
| License Number: | MD34579 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Emergency Medicine |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |