| Organization Name: | PACIFIC PHYSICIAN SERVICES LLC |
| NPI Number: | 1902861651 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBBIE T BREWER (DIRECTOR) |
| Mailing Address: | 425 Highway 42 Petal |
| State: | MS US |
| Postal Code: | 394652891 |
| Phone Number: | 6015844890 |
| Fax Number: | |
| NPI Enumeration Date: | 04/18/2006 |
| NPI Last Update Date: | 03/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |