Msa Alliance, LLC
Family Medicine in Belleville, IL. Organization (NPI-2).
NPI number1730516956
StatusActive
Last updated in NPPESOct 2, 2013
Details
- NPI
- 1730516956
- Entity type
- Organization (NPI-2)
- Legal business name
- Msa Alliance, LLC
- Organization subpart
- No
- Enumeration date
- Oct 2, 2013
- Last updated
- Oct 2, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
4500 Memorial DrMedical Affairs Credentialing Department
Belleville, IL 62226-5360
Phone 618-257-4644 · Fax 618-257-6946
Mailing address
4017 Illinois Route 159Suite 101
Smithton, IL 62285
Phone 618-257-2875 · Fax 618-257-2895
Authorized official
James B. Davis
Executive Director
6182574644
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