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Surgical Clinic, P. C.

Details

Name: Surgical Clinic, P. C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 05 Jul 1973 (51 years ago) (Companies founded in July 1973)
Entity Number: 000-031-243
Register Number: 000031243
Historical Names: Surgical Clinic, Inc.
ZIP code: 36801 (Companies in Lee, 36801)
County: Lee
Place of Formation: Lee County
Principal Address: OPELIKA, AL
Registered Office Street Address: 1206 MORRIS AVEOPELIKA, AL 36801
Authorized Capital: 1,000 NPV
Paid Share Capital: 25

Activities RENDER PROFESSIONAL SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1295762540 2006-06-26 2010-05-07 121 N 20TH ST, BLDG 3, OPELIKA, AL, 368015449, US 121 N 20TH ST, BLDG 3, OPELIKA, AL, 368015449, US

Contacts
Phone +1 334-745-6271
Fax 3347429879

Authorized person
Name DR. JOHN S THOMAS
Role PRESIDENT
Phone 3347456271

Taxonomy
Taxonomy Code 261Q00000X - Clinic/Center
License Number 00012101
State AL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 529402890
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SURGICAL CLINIC, P. C. PROFIT SHARING PLAN 2023 630694006 2024-07-16 SURGICAL CLINIC, P.C. 25
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-07-01
Business code 621111
Sponsor’s telephone number 3347456271
Plan sponsor’s address 121 NORTH 20TH STREET, BUILDING 3, OPELIKA, AL, 36801
SURGICAL CLINIC, P. C. PROFIT SHARING PLAN 2022 630694006 2023-06-26 SURGICAL CLINIC, P.C. 27
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-07-01
Business code 621111
Sponsor’s telephone number 3347456271
Plan sponsor’s address 121 NORTH 20TH STREET, BUILDING 3, OPELIKA, AL, 36801
SURGICAL CLINIC, P. C. PROFIT SHARING PLAN 2021 630694006 2022-06-10 SURGICAL CLINIC, P.C. 25
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-07-01
Business code 621111
Sponsor’s telephone number 3347456271
Plan sponsor’s address 121 NORTH 20TH STREET, BUILDING 3, OPELIKA, AL, 36801
SURGICAL CLINIC, P. C. PROFIT SHARING PLAN 2020 630694006 2021-05-27 SURGICAL CLINIC, P.C. 23
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-07-01
Business code 621111
Sponsor’s telephone number 3347456271
Plan sponsor’s address 121 NORTH 20TH STREET, BUILDING 3, OPELIKA, AL, 36801
SURGICAL CLINIC, P. C. PROFIT SHARING PLAN 2019 630694006 2020-07-07 SURGICAL CLINIC, P.C. 22
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-07-01
Business code 621111
Sponsor’s telephone number 3347456271
Plan sponsor’s address 121 NORTH 20TH STREET, BUILDING 3, OPELIKA, AL, 36801
SURGICAL CLINIC, P. C. PROFIT SHARING PLAN 2018 630694006 2019-06-18 SURGICAL CLINIC, P.C. 27
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-07-01
Business code 621111
Sponsor’s telephone number 3347456271
Plan sponsor’s address 121 NORTH 20TH STREET, BUILDING 3, OPELIKA, AL, 36801
SURGICAL CLINIC, P. C. PROFIT SHARING PLAN 2017 630694006 2018-04-30 SURGICAL CLINIC, P.C. 28
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-07-01
Business code 621111
Sponsor’s telephone number 3347456271
Plan sponsor’s address 121 NORTH 20TH STREET, BUILDING 3, OPELIKA, AL, 36801

Signature of
Role Plan administrator
Date 2018-04-30
Name of individual signing JAMES NORMAN
SURGICAL CLINIC, P. C. PROFIT SHARING PLAN 2016 630694006 2017-06-21 SURGICAL CLINIC, P.C. 28
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-07-01
Business code 621111
Sponsor’s telephone number 3347456271
Plan sponsor’s address 121 NORTH 20TH STREET, BUILDING 3, OPELIKA, AL, 36801

Signature of
Role Plan administrator
Date 2017-06-21
Name of individual signing JAMES NORMAN
SURGICAL CLINIC, P. C. PROFIT SHARING PLAN 2015 630694006 2016-08-17 SURGICAL CLINIC, P.C. 30
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-07-01
Business code 621111
Sponsor’s telephone number 3347456271
Plan sponsor’s address 121 NORTH 20TH STREET, BUILDING 3, OPELIKA, AL, 36801

Signature of
Role Plan administrator
Date 2016-08-17
Name of individual signing JAMES NORMAN
Role Employer/plan sponsor
Date 2016-08-17
Name of individual signing JAMES NORMAN
SURGICAL CLINIC, P.C. PROFIT SHARING PLAN 2014 630694006 2015-07-29 SURGICAL CLINIC, P.C. 27
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-07-01
Business code 621111
Sponsor’s telephone number 3347456271
Plan sponsor’s address 121 NORTH 20TH STREET, BLDG 3, OPELIKA, AL, 36802

Signature of
Role Plan administrator
Date 2015-07-29
Name of individual signing JAMES E. NORMAN
Role Employer/plan sponsor
Date 2015-07-29
Name of individual signing JAMES E. NORMAN

Agent

Name Role
LAZENBY, WILLIAM D Agent

Incorporator

Name Role
LAZENBY, WILLIAM D Incorporator
HAYNES, C DOYLE Incorporator
WEBB, WILLIAM A Incorporator
DEMPSEY, RICHARD L Incorporator

Events

Event Date Event Type Old Value New Value
1995-07-11 Name Change Surgical Clinic, Inc. Surgical Clinic, P. C.
1995-07-11 Capital Change $100,000 Authorized $2,000 Paid In 1,000 NPV Authorized 25 Paid In

Related by officers

LAZENBY, WILLIAM D

Lazenby Family Properties, L.L.C. Medical Arts Center Office Association, Inc. Medical Arts Center of East Alabama, Inc. Professional Associates, Inc. Southeast Evergreen, Inc.

HAYNES, C DOYLE

Professional Associates, Inc.

DEMPSEY, RICHARD L

Dempsey Surgical Clinic, P.C.

Related by address

OPELIKA, AL

Alabama Insurance Service, Inc. B and M Super Market Co., Inc. Blackburn Oil Company, Inc. East Alabama Development, Inc. Brenda-Gay, Inc. Castone Corporation College Insignia, Inc. Choice Realty, Inc. Craftmaster Printers, Inc. DIT Corporation

1206 MORRIS AVEOPELIKA, AL 36801

Lazenby Family Properties, L.L.C.

Date of last update: 30 Jul 2024

Sources: Alabama Secretary of State

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