Msa Alliance, LLC

Plastic and Reconstructive Surgery Physician · Belleville, IL

Organization Active NPI

NPI number 1194033704

Practice location

4600 Memorial Dr
Ste 320
Belleville, IL 62226-5368
Phone
(618) 257-2100
Fax
(618) 257-2169

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NPI record

NPI
1194033704
Entity type
Organization (Type 2)
Enumeration date
September 16, 2010
Last updated
February 25, 2013
Organization subpart
Yes
Parent organization
Msa Alliance, LLC

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Plastic and Reconstructive Surgery Physician Primary 2086S0122X — —

Mailing address

4500 Memorial Dr
Medical Affairs Credentialing Department
Belleville, IL 62226-5360
Phone
(618) 257-4644
Fax
(618) 257-6946

Authorized official

Name
James B. Davis
Title
Executive Director
Phone
(618) 257-4644

About Msa Alliance, LLC

Msa Alliance, LLC is a healthcare organization registered in the NPI registry with the primary taxonomy Plastic and Reconstructive Surgery Physician (code 2086S0122X). The practice location is 4600 Memorial Dr, Ste 320, Belleville, IL 62226-5368. The NPI number 1194033704 was assigned on September 16, 2010 and the record was last updated on February 25, 2013.

The authorized official for this organization is James B. Davis, Executive Director.

Frequently asked questions

What is the NPI number of Msa Alliance, LLC?

The NPI number is 1194033704.

What is the phone number of Msa Alliance, LLC?

The phone number listed for the practice location is (618) 257-2100.

Where is Msa Alliance, LLC located?

4600 Memorial Dr, Ste 320, Belleville, IL 62226-5368.

What is the taxonomy code for Msa Alliance, LLC?

The primary taxonomy code is 2086S0122X – Plastic and Reconstructive Surgery Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.