NPI age
19 years
Enumerated 2006-08-25
● Active
Type 1 · Individual
Walter J Revell JR., MD
Revell is 1 of 12 surgery providers in Vidalia and 1 of 1389 in Georgia.
Primary specialty
Surgery
Licensed in
SC
1 state
Status
Active
No deactivations on record
Last NPPES update
2018-05-01
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1389 active surgery providers in Georgia.
NPI age
19 years
↑ 2 yr above median (17 yr)
State licenses
1 state
14% of peers hold multiple states
Subspecialties
0
28% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-08Enumerated in NPPES
2006
2026
Where they practice
Practice location
305 W 1st St
Vidalia, GA 304743302
Mailing address
305 W 1st St
Vidalia, GA 304743302
Specialties
-
Surgery PrimaryA general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (SC) | 111916 |
Practice context
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
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