Pacific Physician Services Llc | |
425 Highway 42 Petal MS 39465-2891 | |
(601) 584-4890 | |
Not Available |
Full Name | Pacific Physician Services Llc |
---|---|
Speciality | General Practice |
Location | 425 Highway 42, Petal, Mississippi |
Authorized Official Name and Position | Debbie T Brewer (DIRECTOR) |
Authorized Official Contact | 6154657626 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Pacific Physician Services Llc 4000 Meridian Blvd Franklin TN 37067-6325 Ph: (615) 465-7626 | Pacific Physician Services Llc 425 Highway 42 Petal MS 39465-2891 Ph: (601) 584-4890 |
NPI Number | 1902861651 |
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Provider Enumeration Date | 04/18/2006 |
Last Update Date | 03/27/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902861651 | NPI | - | NPPES |
09016137 | Medicaid | MS | |
09270509 | Medicaid | MS | |
09016291 | Medicaid | MS | |
05781336 | Medicaid | MS | |
09016153 | Medicaid | MS | |
01302267 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |