Provider Type Icon

PACIFIC PHYSICIAN SERVICES LLC NPI 1902861651


NPI Information

NPI: 1902861651
Provider Name: PACIFIC PHYSICIAN SERVICES LLC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
425 HIGHWAY 42
PETAL, MS
ZIP 39465
Phone: (601) 584-4890
Get Directions

PACIFIC PHYSICIAN SERVICES LLC is a general practice in Petal, MS. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee PACIFIC PHYSICIAN SERVICES LLC NPI is 1902861651. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

425 HIGHWAY 42
PETAL, MS
ZIP 39465-891
Phone: (601) 584-4890

The provider's authorized official is Debbie T Brewer .
The authorized official title is Director and has the following contact phone number (615) 465-7626.

The enumeration date for this NPI number is 4/18/2006 and was last updated on 3/27/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral PracticeYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
105781336MEDICAIDMISSISSIPPI
209016137MEDICAIDMISSISSIPPI
309270509MEDICAIDMISSISSIPPI
4C02720MEDICARE ID-TYPE UNSPECIFIEDMISSISSIPPI
509016153MEDICAIDMISSISSIPPI
601302267MEDICAIDMISSISSIPPI
709016291MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.