Organization
PACIFIC PHYSICIAN SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
(615) 465-7626
Entity
Organization
Contact information
Practice address
8803 S 101ST EAST AVE, STE. 145, TULSA, OK 74133-5726
(918) 250-2033
Mailing address
8803 S 101ST EAST AVE, STE. 145, TULSA, OK 74133-5726
(918) 250-2033
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/11/2006
Last updated
01/11/2008
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