Individual
MR. DONOVAN SCOTT WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 MERCY WAY, JOPLIN, MO 64804-4524
(417) 781-2727
Mailing address
PO BOX 11405, FORT SMITH, AR 72917-1405
(479) 785-2555
(479) 785-3555
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2015043775
MO
367500000X
Certified Registered Nurse Anesthetist
C01497
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156956001
—
AR
05
—
200053830A
—
OK
Enumeration date
09/21/2006
Last updated
01/22/2025
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