Provider Demographics
NPI:1619246485
Name:OA ASSOCIATES LLC
Entity Type:Organization
Organization Name:OA ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-257-6301
Mailing Address - Street 1:4700 MEMORIAL DR
Mailing Address - Street 2:STE. 340
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62226-5370
Mailing Address - Country:US
Mailing Address - Phone:618-234-9884
Mailing Address - Fax:618-235-9020
Practice Address - Street 1:4700 MEMORIAL DR
Practice Address - Street 2:STE. 340
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62226-5370
Practice Address - Country:US
Practice Address - Phone:618-234-9884
Practice Address - Fax:618-235-9020
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OA ASSOCIATES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-22
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty