Organization
MSA ALLIANCE, LLC
Active
Parent organization
MSA ALLIANCE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MSA ALLIANCE, LLC
Authorized official
JAMES B. DAVIS (EXECUTIVE DIRECTOR)
(618) 257-4644
Entity
Organization
Contact information
Practice address
4600 MEMORIAL DR, STE 320, BELLEVILLE, IL 62226-5368
(618) 257-2100
(618) 257-2169
Mailing address
4500 MEMORIAL DR, MEDICAL AFFAIRS CREDENTIALING DEPARTMENT, BELLEVILLE, IL 62226-5360
(618) 257-4644
(618) 257-6946
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
09/16/2010
Last updated
02/25/2013
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