# OA ASSOCIATED LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639692973
- **Authorized official:** JAMES B DAVIS (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (618) 257-4644

## Contact information

- **Practice address:** 1414 CROSS ST STE 110, SHILOH, IL 62269-2988
- **Practice address phone:** (618) 234-9884
- **Practice address fax:** (618) 235-9020
- **Mailing address:** 4500 MEMORIAL DR, BELLEVILLE, IL 62226-5360
- **Mailing address phone:** (618) 257-4644
- **Mailing address fax:** (618) 257-6946

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | NULL | — |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 07/19/2017
- **Last updated:** 07/19/2017