Healthcare Provider Details

I. General information

NPI: 1144274622
Provider Name (Legal Business Name): FIELD MEMORIAL COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

434 N CAPTAIN GLOSTER DR
GLOSTER MS
39638-3401
US

IV. Provider business mailing address

434 N CAPTAIN GLOSTER DR
GLOSTER MS
39638-3401
US

V. Phone/Fax

Practice location:
  • Phone: 601-225-4711
  • Fax: 601-225-7861
Mailing address:
  • Phone: 601-225-4711
  • Fax: 601-225-7861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: BERNARD RICHARD WILLIAMS
Title or Position: CEO
Credential:
Phone: 601-890-0500