| 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 |
|---|---|
| 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 |
Petal High School Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1145 Highway 42, Petal, MS 39465 Phone: 601-545-8700 Fax: 601-450-2493 | |
Central Family Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 126 W Central Ave, Petal, MS 39465 Phone: 601-296-2552 Fax: 601-296-2397 | |
Petal Primary School Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 60 Herrington Rd, Petal, MS 39465 Phone: 601-545-8700 Fax: 601-450-2493 | |
Runnelstown School Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9214 Highway 42, Petal, MS 39465 Phone: 601-545-8700 Fax: 601-582-5461 | |
Immediate Care- Petal Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 50 Parkway Ln, Petal, MS 39465 Phone: 601-705-2897 Fax: 601-584-6457 | |
Runnelstown Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 15 Pumping Station Rd, Petal, MS 39465 Phone: 601-583-1559 Fax: 601-583-1573 | |
Petal Middle School Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 203 Highway 42, Petal, MS 39465 Phone: 601-584-6301 Fax: 601-450-2493 |