Organization
MSA ALLIANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES B. DAVIS FACHE, MBA, MHSA (EXECUTIVE DIRECTOR)
(618) 257-6301
Entity
Organization
Contact information
Practice address
4550 MEMORIAL DRIVE, STE. 280, BELLEVILLE, IL 62226
(618) 277-3109
(618) 233-5696
Mailing address
4500 MEMORIAL DRIVE, MEDICAL AFFAIRS OFFICE, BELLEVILLE, IL 62226
(618) 257-6568
(618) 257-6946
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208800000X
Urology Physician
—
—
Other
Enumeration date
03/10/2010
Last updated
01/09/2014
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