| Name: | Valley Radiology, P.A. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Association |
| Status: | Dissolved |
| Date of registration: | 13 Aug 1972 (52 years ago) |
| Date of dissolution: | 17 Sep 2018 |
| Entity Number: | 000-008-027 |
| Register Number: | 000008027 |
| Historical Names: |
Thomas A. Gibson, M.D., P.A.
|
| County: | Jackson |
| Place of Formation: | Jackson County |
| Principal Address: | 507 HARLEY STREETSCOTTSBORO, AL 35768 |
| Principal Address ZIP Code: | 35768 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083674287 | 2006-03-23 | 2011-07-13 | 1108B S BROAD ST, SCOTTSBORO, AL, 357682514, US | 1108B S BROAD ST, SCOTTSBORO, AL, 357682514, US | |||||||||||||||||||||||
|
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| Phone | +1 256-259-2323 |
| Fax | 2562599397 |
Authorized person
| Name | DR. JOHN L REICHLE |
| Role | M.D. |
| Phone | 2562592323 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 60273 |
| State | AL |
| Name | Role |
|---|---|
| GIBSON, THOMAS A | Member |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 1979-11-01 | Name Change | Thomas A. Gibson, M.D., P.A. | Valley Radiology, P.A. |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
