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General NPI Number Information
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NPI Number | 1023340874
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Entity Type | Organization
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Legal Business Name | FIELD MEMORIAL COMMUNITY HOSPITAL
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Dates
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Enumeration Date | 02/04/2010
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Last Update Date | 02/04/2010
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Provider Practice Location Address
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Address Line | 260 E MAIN ST
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City | CENTREVILLE
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State | MS
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Zip | 39631-4200
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Country | US
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Telephone | 601-645-5361
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Fax |
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Provider Business Mailing Address
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Address Line | 270 W MAIN STREET
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City | CENTREVILLE
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State | MS
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Zip | 39631
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Country | US
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Telephone | 601-645-5221
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JEREMY CHAD NETTERVILLE
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Credential |
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Telephone | 601-645-5221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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