MEDICARE: PACIFIC PHYSICIAN SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902861651
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACIFIC PHYSICIAN SERVICES LLC

Provider Business Mailing Address
First Line	:	4000 MERIDIAN BLVD
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-6325
Country	:	US
Telephone Number	:	615-465-7626
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 HIGHWAY 42
Second Line	:
City	:	PETAL
State	:	MS
Zip	:	39465-2891
Country	:	US
Telephone Number	:	601-584-4890
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DEBBIE T BREWER
Credential	:
Telephone Number	:	615-465-7626

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	03/27/2012

Similar Medicare Providers

1629911698 — MAGNOLIA ORTHODONTICS OF PETAL, PLLC
Practice Location Address:

35 BEECH LN
PETAL, MS
39465-9457

Practice Phone: 601-305-9955
Practice Fax: 601-305-9977

1710984539 — GERALYNN G. MORRISON M.D.
Practice Location Address:

102 RED MAPLE TRL
PETAL, MS
39465-2678

Practice Phone: 601-310-6455
Practice Fax:

1962494229 — LILLIAN GIBB PT
Practice Location Address:

1227 HWY 42 , SUITE 110
PETAL, MS
39465-2790

Practice Phone: 601-545-2728
Practice Fax: 601-545-2792

1235111311 — BEDFORD CARE CENTER OF PETAL, LLC
Practice Location Address:

908 SOUTH GEORGE STREET
PETAL, MS
39465-2014

Practice Phone: 601-544-7441
Practice Fax: 601-582-3217

1780646943 — ANNA CHRISTINE POWELL ATC, LAT, CSCS
Practice Location Address:

1145 HIGHWAY 42
PETAL, MS
39465-9740

Practice Phone: 601-544-0500
Practice Fax: 601-544-0505

1841247954 — MR. FRED THOMAS HURST JR. CRNA
Practice Location Address:

68 REDFERN TRL
PETAL, MS
39465-9415

Practice Phone: 601-310-6813
Practice Fax:

Directions to “PACIFIC PHYSICIAN SERVICES LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.