Name: | Michael O. Stutts, O.D., LLC |
Jurisdiction: | Alabama |
Legal type: | Domestic Limited Liability Company |
Status: | Exists |
Date of registration: | 02 Mar 2011 (14 years ago) |
Entity Number: | 000-005-017 |
Register Number: | 000005017 |
County: | Lauderdale |
Place of Formation: | Colbert County |
Registered Office Street Address: | 208 N WALNUT STREETFLORENCE, AL 35631 |
Registered Office Street Address ZIP Code: | 35631 |
Activities
PROFESSIONAL OPTOMETRY PRACTICE
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1013200542 | 2011-05-17 | 2011-05-17 | 401 COX BLVD, SUITE B, SHEFFIELD, AL, 356604059, US | 401 COX BLVD, SUITE B, SHEFFIELD, AL, 356604059, US | |||||||||||||||||||||||||
|
Phone | +1 256-314-4424 |
Fax | 2563144535 |
Authorized person
Name | DR. MICHAEL O STUTTS |
Role | OPTOMETIRST |
Phone | 2563144424 |
Taxonomy
Taxonomy Code | 152W00000X - Optometrist |
License Number | S654TA084 |
State | AL |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID |
Number | 127255 |
State | AL |
Name | Role |
---|---|
SNEED, LARRY D | Agent |
Name | Role | Address |
---|---|---|
STUTTS, MICHAEL O | Organizer | 605 RIVER BLUFF DRIVESHEFFIELD, AL 35660 |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State