| 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) (Companies founded in March 2011) |
| Entity Number: | 000-005-017 |
| Register Number: | 000005017 |
| ZIP code: | 35631 (Companies in Lauderdale, 35631) |
| County: | Lauderdale |
| Place of Formation: | Colbert County |
| Registered Office Street Address: | 208 N WALNUT STREETFLORENCE, AL 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 | |||||||||||||||||||||||||
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| 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
