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Vyshali Reddy Loupe, MD, LLC

Details

Name: Vyshali Reddy Loupe, MD, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Dissolved
Date of registration: 20 Sep 2011 (13 years ago) (Companies founded in September 2011)
Date of dissolution: 26 Oct 2015
Entity Number: 000-025-747
Register Number: 000025747
ZIP code: 35768 (Companies in Jackson, 35768)
County: Jackson
Place of Formation: Jackson County
Registered Office Street Address: 126 E. PEACHTREE STREETSCOTTSBORO, AL 35768

Activities PERFORM MEDICAL TREATMENT AND ALL INCIDENTALS RELATED THERETO

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1295018182 2011-09-27 2011-09-27 PO BOX 1050, 380 WOODS COVE ROAD, SCOTTSBORO, AL, 357681050, US 331 PARKS AVE, SUITE A, SCOTTSBORO, AL, 357682411, US

Contacts

Phone +1 256-218-3856
Fax 2562183536
Phone +1 256-259-1635
Fax 2562591685

Authorized person

Name MR. DAN B NEWELL
Role CHIEF FINANCIAL OFFICER
Phone 2562183856

Taxonomy

Taxonomy Code 207R00000X - Internal Medicine Physician
License Number 30028
State AL
Is Primary Yes

Agent

Name Role
LACKEY, GARY W Agent

Organizer

Name Role Address
NEWELL, DAN Organizer No data
BRYANT, KIM Organizer 75 14TH STREET SUITE 2710ATLANTA, GA 30309

Date of last update: 30 Jul 2024

Sources: Alabama Secretary of State