Healthcare Provider Details
I. General information
NPI: 1669818480
Provider Name (Legal Business Name): FIELD MEMORIAL COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/20/2013
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1410 MAIN ST E
LIBERTY MS
39645-7268
US
IV. Provider business mailing address
1410 E MAIN ST
LIBERTY MS
39645-7268
US
V. Phone/Fax
- Phone: 601-657-8820
- Fax: 601-657-9091
- Phone: 601-657-8820
- Fax: 601-657-9091
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BERNARD
RICHARD
WILLIAMS
Title or Position: CEO
Credential:
Phone: 601-890-0545