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 A-480, BELLEVILLE, IL 62226-5372
(618) 222-1020
(618) 222-1039
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
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
07/28/2010
Last updated
02/21/2013
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