Thomas John Revak
Orthopaedic Surgeon
1008 South Spring Avenue Orthopaedic Surgery, Slucare Administrative Pavillion F
Saint Louis
, Missouri 63110-2539
Thomas John Revak
Orthopaedic Surgeon
1008 South Spring Avenue Orthopaedic Surgery, Slucare Administrative Pavillion F
Saint Louis
, Missouri 63110-2539
(314) 977-5350
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About
Features
Specialties
- Orthopaedic Surgeon
Languages spoken
- English
Location
First Address
- Thomas John Revak
- 1008 South Spring Avenue Orthopaedic Surgery, Slucare Administrative Pavillion F
- Saint Louis, MO
- Zip : 63110-2539
- Phone : (314) 977-5350
Second Address
- Thomas John Revak
- 1008 South Spring Avenue Orthopaedic Surgery, Slucare Administrative Pavillion F
- Saint Louis, MO
- Zip : 63110-2539
- Phone : (314) 977-5350
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgeon | 2015015073 | MO |
| N | 207X00000X | Orthopaedic Surgeon | OT014391 | PA |
National Provider Identifier
| NPI | 1023306859 |
|---|---|
| Provider Name | Thomas John Revak |
| First Address | Saint Louis, MO 63110-2539 |
| Second Address | Saint Louis, MO 63110-2539 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/07/2011 |
| Last Update Date | 01/03/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| OT014391 | TRAINING LICENSES (01) | PA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.