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
4550 MEMORIAL DR, STE 350, BELLEVILLE, IL 62226-5372
(618) 239-9690
(618) 239-9692
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
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
07/28/2010
Last updated
02/25/2013
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