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General NPI Number Information
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NPI Number | 1831099597
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Entity Type | Organization
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Legal Business Name | WILLOW PERIOPERATIVE SERVICES LLC
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Dates
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Enumeration Date | 11/06/2026
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Last Update Date | 11/06/2026
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Provider Practice Location Address
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Address Line | 2704 W OXFORD LOOP STE 117
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City | OXFORD
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State | MS
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Zip | 38655-5728
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Country | US
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Telephone | 662-550-4299
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Fax |
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Provider Business Mailing Address
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Address Line | 2704 W OXFORD LOOP STE 117
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City | OXFORD
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State | MS
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Zip | 38655-5728
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CRNA
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Name | DAVID MCCULLEN
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Credential |
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Telephone | 662-550-4299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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