# HOSPITAL AUTHORITY OF LIBERTY COUNTY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LIBERTY FAMILY MEDICINE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356636534
- **Authorized official:** DEREK ROZIER (CFO)
- **Authorized official phone:** (912) 369-9427

## Contact information

- **Practice address:** 455 S.MAIN STREET STE 104, HINESVILLE, GA 31313
- **Practice address phone:** (912) 876-5644
- **Practice address fax:** (912) 408-3457
- **Mailing address:** 455 S MAIN STREET, SUITE 104, HINESVILLE, GA 31313-4354
- **Mailing address phone:** (912) 876-5644
- **Mailing address fax:** (912) 877-6341

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 065972 | GA | Yes |

## Other

- **Enumeration date:** 06/15/2011
- **Last updated:** 01/06/2022