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Selma Women's Health, LLC

Details

Name: Selma Women's Health, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 04 Mar 2011 (14 years ago)
Entity Number: 000-005-096
Register Number: 000005096
County: Dallas
Place of Formation: Dallas County
Registered Office Street Address: 1023 MEDICAL CENTER PARKWAY STE 301SELMA, AL 36701
Registered Office Street Address ZIP Code: 36701

Activities PROVIDE MEDICAL SERVICES FOR OBSTETRICS AND GYNECOLOGY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1245520063 2011-04-13 2013-03-05 203 VAUGHAN MEMORIAL DR, SELMA, AL, 367016950, US 203 VAUGHAN MEMORIAL DR, SELMA, AL, 367016950, US

Contacts

Phone +1 334-874-3633
Fax 3348754331

Authorized person

Name DR. BRENT WHIDDON
Role OWNER/MEDICAL DOCTOR
Phone 3348743633

Taxonomy

Taxonomy Code 174400000X - Specialist
License Number MD.30813
State AL
Is Primary Yes

Organizer

Name Role Address
WHIDDON, OLIVIA J Organizer 322 BUTTONWOOD COURTCOPPELL, TX 75019
WHIDDON, BRENT B Organizer 322 BUTTONWOOD COURTCOPPELL, TX 75019

Agent

Name Role
BRENT B WHIDDON MD Agent

Date of last update: 30 Jul 2024

Sources: Alabama Secretary of State