Individual
WILLIAM JODY CROMWELL SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1002 E MADISON ST, HOUSTON, MS 38851-2417
(662) 456-1163
Mailing address
1002 E MADISON ST, HOUSTON, MS 38851-2417
(662) 456-1163
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R535672
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09013354
—
MS
01
—
1366465502
TRACE HOSPITAL NPI
MS
Enumeration date
07/18/2006
Last updated
04/17/2014
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