Organization
OA ASSOCIATED 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
1414 CROSS ST STE 110, SHILOH, IL 62269-2988
(618) 234-9884
(618) 235-9020
Mailing address
4500 MEMORIAL DR, BELLEVILLE, IL 62226-5360
(618) 257-4644
(618) 257-6946
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
Other
Enumeration date
07/19/2017
Last updated
07/19/2017
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