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Radiology Associates of Dothan, P.C.

Details

Name: Radiology Associates of Dothan, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 11 Jun 1969 (55 years ago)
Entity Number: 000-015-310
Register Number: 000015310
Historical Names: Radiology Associates of Dothan, P.A.
County: Houston
Place of Formation: Houston County
Principal Address: DOTHAN, AL
Registered Office Street Address: 1900 FAIRVIEW AVEDOTHAN, AL 36301
Registered Office Street Address ZIP Code: 36301
Authorized Capital: $5,000

Activities MEDICAL SERVICES/RADIOLOGY PRACTICE/SURGICAL SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1083697718 2005-11-28 2010-01-15 2015 ALEXANDER DR, DOTHAN, AL, 363013003, US 1900 FAIRVIEW AVE, DOTHAN, AL, 363013008, US

Contacts
Phone +1 334-671-1696
Fax 3347940721
Phone +1 334-793-9511

Authorized person
Name WILLIAM W BECKETT JR.
Role PRESIDENT
Phone 3347939511

Taxonomy
Taxonomy Code 2085N0700X - Neuroradiology Physician
Is Primary No
Taxonomy Code 2085R0202X - Diagnostic Radiology Physician
Is Primary Yes
Taxonomy Code 2085R0204X - Vascular & Interventional Radiology Physician
Is Primary No

Other Provider Identifiers
Issuer MEDICAID
Number 274277202
State AL
Issuer MEDICAID
Number 300040735A
State GA
Issuer MEDICAID
Number 000060028
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
RADIOLOGY ASSOCIATES OF DOTHAN, P.A. PROFIT SHARING PLAN 2023 630577764 2024-07-26 RADIOLOGY ASSOCIATES OF DOTHAN, P.A. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1970-06-01
Business code 621111
Sponsor’s telephone number 3347939511
Plan sponsor’s mailing address 1900 FAIRVIEW AVE, DOTHAN, AL, 36301
Plan sponsor’s address 1900 FAIRVIEW AVE, DOTHAN, AL, 36301

Number of participants as of the end of the plan year
Active participants 16
Other retired or separated participants entitled to future benefits 1
Number of participants with account balances as of the end of the plan year 17
RADIOLOGY ASSOCIATES OF DOTHAN, P.A. PROFIT SHARING PLAN 2022 630577764 2023-07-26 RADIOLOGY ASSOCIATES OF DOTHAN, P.A. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1970-06-01
Business code 621111
Sponsor’s telephone number 3347939511
Plan sponsor’s mailing address 1900 FAIRVIEW AVE, DOTHAN, AL, 36301
Plan sponsor’s address 1900 FAIRVIEW AVE, DOTHAN, AL, 36301

Number of participants as of the end of the plan year
Active participants 16
Other retired or separated participants entitled to future benefits 1
Number of participants with account balances as of the end of the plan year 17
RADIOLOGY ASSOCIATES OF DOTHAN, P.A. PROFIT SHARING PLAN 2021 630577764 2022-07-21 RADIOLOGY ASSOCIATES OF DOTHAN, P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1970-06-01
Business code 621111
Sponsor’s telephone number 3347939511
Plan sponsor’s mailing address 1900 FAIRVIEW AVE, DOTHAN, AL, 36301
Plan sponsor’s address 1900 FAIRVIEW AVE, DOTHAN, AL, 36301

Number of participants as of the end of the plan year
Active participants 14
Other retired or separated participants entitled to future benefits 1
Number of participants with account balances as of the end of the plan year 15
RADIOLOGY ASSOCIATES OF DOTHAN, P.A. PROFIT SHARING PLAN 2020 630577764 2021-07-30 RADIOLOGY ASSOCIATES OF DOTHAN, P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1970-06-01
Business code 621111
Sponsor’s telephone number 3347939511
Plan sponsor’s mailing address 1900 FAIRVIEW AVE, DOTHAN, AL, 36301
Plan sponsor’s address 1900 FAIRVIEW AVE, DOTHAN, AL, 36301

Number of participants as of the end of the plan year
Active participants 12
Number of participants with account balances as of the end of the plan year 12
RADIOLOGY ASSOCIATES OF DOTHAN, P.A. PROFIT SHARING PLAN 2019 630577764 2020-06-16 RADIOLOGY ASSOCIATES OF DOTHAN, P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1970-06-01
Business code 621111
Sponsor’s telephone number 3347939511
Plan sponsor’s mailing address 1900 FAIRVIEW AVE, DOTHAN, AL, 36301
Plan sponsor’s address 1900 FAIRVIEW AVE, DOTHAN, AL, 36301

Number of participants as of the end of the plan year
Active participants 12
Number of participants with account balances as of the end of the plan year 12
RADIOLOGY ASSOCIATES OF DOTHAN, P.A. PROFIT SHARING PLAN 2018 630577764 2019-07-29 RADIOLOGY ASSOCIATES OF DOTHAN, P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1970-06-01
Business code 621111
Sponsor’s telephone number 3347939511
Plan sponsor’s mailing address 1900 FAIRVIEW AVE, DOTHAN, AL, 36301
Plan sponsor’s address 1900 FAIRVIEW AVE, DOTHAN, AL, 36301

Number of participants as of the end of the plan year
Active participants 13
Number of participants with account balances as of the end of the plan year 13
RADIOLOGY ASSOCIATES OF DOTHAN, P.A. PROFIT SHARING PLAN 2017 630577764 2018-08-28 RADIOLOGY ASSOCIATES OF DOTHAN, P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1970-06-01
Business code 621111
Sponsor’s telephone number 3347939511
Plan sponsor’s mailing address 1900 FAIRVIEW AVE, DOTHAN, AL, 36301
Plan sponsor’s address 1900 FAIRVIEW AVE, DOTHAN, AL, 36301

Number of participants as of the end of the plan year
Active participants 14
Number of participants with account balances as of the end of the plan year 14
RADIOLOGY ASSOCIATES OF DOTHAN, P.A. PROFIT SHARING PLAN 2016 630577764 2017-10-13 RADIOLOGY ASSOCIATES OF DOTHAN, P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1970-06-01
Business code 621111
Sponsor’s telephone number 3347939511
Plan sponsor’s mailing address 1900 FAIRVIEW AVE, DOTHAN, AL, 36301
Plan sponsor’s address 1900 FAIRVIEW AVE, DOTHAN, AL, 36301

Number of participants as of the end of the plan year
Active participants 12
Number of participants with account balances as of the end of the plan year 12
RADIOLOGY ASSOCIATES OF DOTHAN, P.A. PROFIT SHARING PLAN 2015 630577764 2016-09-07 RADIOLOGY ASSOCIATES OF DOTHAN, P.A. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1970-06-01
Business code 621111
Sponsor’s telephone number 3347939511
Plan sponsor’s mailing address 1900 FAIRVIEW AVE, DOTHAN, AL, 36301
Plan sponsor’s address 1900 FAIRVIEW AVE, DOTHAN, AL, 36301

Number of participants as of the end of the plan year
Active participants 13
Other retired or separated participants entitled to future benefits 1
Number of participants with account balances as of the end of the plan year 14
RADIOLOGY ASSOCIATES OF DOTHAN, P.A. PROFIT SHARING PLAN 2014 630577764 2015-09-15 RADIOLOGY ASSOCIATES OF DOTHAN, P.A. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1970-06-01
Business code 621111
Sponsor’s telephone number 3347939511
Plan sponsor’s mailing address 1900 FAIRVIEW AVE, DOTHAN, AL, 36301
Plan sponsor’s address 1900 FAIRVIEW AVE, DOTHAN, AL, 36301

Number of participants as of the end of the plan year
Active participants 13
Other retired or separated participants entitled to future benefits 3
Number of participants with account balances as of the end of the plan year 16

Agent

Name Role
BECKETT, WILLIAM W Agent

Incorporator

Name Role
BECKETT, WILLIAM W Incorporator

Events

Event Date Event Type Old Value New Value
2002-02-21 Name Change Radiology Associates of Dothan, P.A. Radiology Associates of Dothan, P.C.

Awards

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
PO AWARD DJBMNAIVB231034 2009-04-29 2009-04-29 2009-09-30
Unique Award Key CONT_AWD_DJBMNAIVB231034_1540_-NONE-_-NONE-
Awarding Agency Department of Justice
Link View Page

Description
Title RADIOLOGY PROCEDURE
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q522: RADIOLOGY SERVICES

Recipient Details
Recipient RADIOLOGY ASSOCIATES OF DOTHAN
UEI DLX8ALKDPS71
Legacy DUNS 093179901
Recipient Address UNITED STATES, 1900 FAIRVIEW AVE, DOTHAN, 363013008

Related by officers

BECKETT, WILLIAM W

SWB INVESTMENTS, LLC

Related by address

DOTHAN, AL

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1900 FAIRVIEW AVEDOTHAN, AL 36301

Prim, Lennicx, Veale,Turner, Holloway, King, Beckett, Syklawer and Brink, LLP

Date of last update: 30 Jul 2024

Sources: Alabama Secretary of State

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