Healthcare Provider Details

I. General information

NPI: 1184806747
Provider Name (Legal Business Name): FIELD MEMORIAL COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2007
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

178 HIGHWAY 24 E
CENTREVILLE MS
39631-4171
US

IV. Provider business mailing address

PO BOX 639
CENTREVILLE MS
39631-0639
US

V. Phone/Fax

Practice location:
  • Phone: 608-890-0500
  • Fax:
Mailing address:
  • Phone: 601-645-5221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BERNARD RICHARD WILLIAMS
Title or Position: CEO
Credential:
Phone: 601-890-0545