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Organization

WILLOW ANESTHESIA SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID GARRETT MCCULLEN CRNA (MEMBER)
(662) 550-4299
Entity
Organization

Contact information

Practice address
2704 W OXFORD LOOP, SUITE 117, OXFORD, MS 38655-5714
(662) 550-4299
(662) 580-4324
Mailing address
2704 W OXFORD LOOP STE 117, OXFORD, MS 38655-5728
(662) 550-4299
(662) 580-4324

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02537897
MS
01
DP9729
RR MEDICARE
Enumeration date
09/18/2009
Last updated
04/29/2026
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