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General NPI Number Information
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NPI Number | 1477917656
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Entity Type | Organization
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Legal Business Name | OA ASSOCIATES, LLC
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Dates
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Enumeration Date | 04/13/2016
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Last Update Date | 04/28/2016
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Provider Practice Location Address
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Address Line | 1404 CROSS ST 2ND FLOOR SUITE 2941
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City | SHILOH
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State | IL
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Zip | 62269-2988
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Country | US
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Telephone | 618-234-9884
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Fax |
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Provider Business Mailing Address
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Address Line | 4500 MEMORIAL DRIVE MEMORIAL HOSPITAL MEDICAL AFFAIRS CREDENTIALING DEPT
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City | BELLEVILLE
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State | IL
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Zip | 62226
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Country | US
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Telephone | 618-257-4644
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JAMES B DAVIS
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Credential |
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Telephone | 618-257-4644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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