Organization
PACIFIC PHYSICIAN SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE T BREWER (DIRECTOR)
(615) 465-7626
Entity
Organization
Contact information
Practice address
425 HIGHWAY 42, PETAL, MS 39465-2891
(601) 584-4890
Mailing address
4000 MERIDIAN BLVD, FRANKLIN, TN 37067-6325
(615) 465-7626
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01302267
—
MS
05
—
05781336
—
MS
05
—
09016137
—
MS
05
—
09016153
—
MS
05
—
09016291
—
MS
05
—
09270509
—
MS
Enumeration date
04/18/2006
Last updated
03/27/2012
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