| Pacific Physician Services, Llc | |
|
200 Hospital Dr W Hattiesburg MS 39402-1346 | |
| (601) 296-3000 | |
| Not Available |
| Full Name | Pacific Physician Services, Llc |
|---|---|
| Speciality | General Practice |
| Location | 200 Hospital Dr W, Hattiesburg, Mississippi |
| Authorized Official Name and Position | Debbie Brewer (DIRECTOR) |
| Authorized Official Contact | 8778929813 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Physician Services, Llc Po Box 689022 Franklin TN 37068-9022 Ph: (615) 465-7000 | Pacific Physician Services, Llc 200 Hospital Dr W Hattiesburg MS 39402-1346 Ph: (601) 296-3000 |
| NPI Number | 1316968084 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 06/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316968084 | NPI | - | NPPES |
| 00525592 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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