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Organization
CA GROUP, LLC
Active
Organization
CA GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES B DAVIS (EXECUTIVE DIRECTOR)
(618) 257-4644
Entity
Organization
Contact information
Practice address
1404 CROSS ST, SUITE 2940, SHILOH, IL 62269-2988
(618) 607-3700
(618) 624-4841
Mailing address
4500 MEMORIAL DRIVE, MEMORIAL HOSPITAL CREDENTIALING DEPARTMENT, BELLEVILLE, IL 62226
(618) 257-4644
(618) 257-6946
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
—
NULL
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
—
—
207RI0011X
Interventional Cardiology Physician
—
NULL
207RI0011X
Interventional Cardiology Physician
—
—
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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