NPI 1003295213

Msa Alliance, LLC Dba-Southern Illinois Vascular and Vein Surgery

Organisation Vascular Surgery Physician Maryville, IL

Practice location

Address: 6810 State Route 162 Suite 100, Maryville, IL 62062
Phone: (618) 334-2425
Fax: (618) 222-1039
Mailing address: 4500 Memorial Drive Credentialing Dept Memorial Hospital Medical Affairs, Belleville, IL 62226

Authorised official

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

Registered specialties

Vascular Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2086S0129X

Other Surgery providers in Illinois →

Registry record

NPI: 1003295213
Entity type: Organization
NPI issued: 20 May 2015
Record last updated: 20 May 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.