NPI 1316374457

Msa Alliance, LLC

Organisation Family Medicine Physician Belleville, IL

Practice location

Address: 4500 Memorial Dr Medical Affairs Credentialing Department, Belleville, IL 62226-5360
Phone: (618) 257-4644
Fax: (618) 257-6946
Mailing address: 830 Admiral Weinel Blvd, Columbia, IL 62236-1992

Authorised official

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

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in Illinois →

Registry record

NPI: 1316374457
Entity type: Organization
NPI issued: 3 Oct 2013
Record last updated: 3 Oct 2013

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.