# MSA ALLIANCE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MSA ALLIANCE, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1154661825
- **Legal business name:** MSA ALLIANCE, LLC
- **Authorized official:** JAMES B. DAVIS (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (618) 257-4644

## Contact information

- **Practice address:** 1 BROADWAY PLZ, SPARTA, IL 62286-1800
- **Practice address phone:** (618) 222-1020
- **Mailing address:** 4500 MEMORIAL DR, MEDICAL AFFAIRS CREDENTIAL DEPT, BELLEVILLE, IL 62226-5360
- **Mailing address phone:** (618) 257-4644
- **Mailing address fax:** (618) 257-6946

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/18/2013
- **Last updated:** 02/22/2013