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Family Practice Clinic of Dothan, P.A.

Details

Name: Family Practice Clinic of Dothan, P.A.
Jurisdiction: Alabama
Legal type: Domestic Professional Association
Status: Exists
Date of registration: 09 May 1974 (51 years ago) (Companies founded in May 1974)
Entity Number: 000-033-246
Register Number: 000033246
ZIP code: 36303 (Companies in Houston, 36303)
County: Houston
Place of Formation: Houston County
Principal Address: 1245 WESTGATE PKWYDOTHAN, AL 36303

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1932132370 2006-07-09 2020-08-22 1245 WESTGATE PKWY, DOTHAN, AL, 363032151, US 1812 E MAIN ST, DOTHAN, AL, 363013000, US

Contacts
Phone +1 334-793-9595
Fax 3347931578
Phone +1 334-794-8771

Authorized person
Name MRS. JOYCE HUFFAKER
Role PRACTICE MANAGER
Phone 3347939595

Taxonomy
Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FAMILY PRACTICE CLINIC OF DOTHAN, P.A. PROFIT SHARING PLAN 2017 630659133 2018-06-14 FAMILY PRACTICE CLINIC OF DOTHAN, P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-04-04
Business code 621111
Sponsor’s telephone number 3347939595
Plan sponsor’s address 1245 WESTGATE PARKWAY, DOTHAN, AL, 36303
FAMILY PRACTICE CLINIC OF DOTHAN, P.A. PROFIT SHARING PLAN 2016 630659133 2017-07-27 FAMILY PRACTICE CLINIC OF DOTHAN, P.A. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-04-04
Business code 621111
Sponsor’s telephone number 3347939595
Plan sponsor’s address 1245 WESTGATE PARKWAY, DOTHAN, AL, 36303
FAMILY PRACTICE CLINIC OF DOTHAN, P.A. PROFIT SHARING PLAN 2015 630659133 2016-09-30 FAMILY PRACTICE CLINIC OF DOTHAN, P.A. 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-04-04
Business code 621111
Sponsor’s telephone number 3347939595
Plan sponsor’s address 1245 WESTGATE PARKWAY, DOTHAN, AL, 36303
FAMILY PRACTICE CLINIC OF DOTHAN, P.A. PROFIT SHARING PLAN 2014 630659133 2015-10-14 FAMILY PRACTICE CLINIC OF DOTHAN, P.A. 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-04-04
Business code 621111
Sponsor’s telephone number 3347939595
Plan sponsor’s address 1245 WESTGATE PARKWAY, DOTHAN, AL, 36303
FAMILY PRACTICE CLINIC OF DOTHAN, P.A. PROFIT SHARING PLAN 2013 630659133 2014-10-06 FAMILY PRACTICE CLINIC OF DOTHAN, P.A. 39
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-04-04
Business code 621111
Sponsor’s telephone number 3347939595
Plan sponsor’s address 1245 WESTGATE PARKWAY, DOTHAN, AL, 36303
FAMILY PRACTICE CLINIC OF DOTHAN, P.A. PROFIT SHARING PLAN 2012 630659133 2013-10-03 FAMILY PRACTICE CLINIC OF DOTHAN, P.A. 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-04-04
Business code 621111
Sponsor’s telephone number 3347939595
Plan sponsor’s address 1245 WESTGATE PARKWAY, DOTHAN, AL, 36303

Signature of
Role Plan administrator
Date 2013-10-03
Name of individual signing RODDY D COOK
FAMILY PRACTICE CLINIC OF DOTHAN, P.A. PROFIT SHARING PLAN 2011 630659133 2012-10-11 FAMILY PRACTICE CLINIC OF DOTHAN, P.A. 44
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-04-04
Business code 621111
Sponsor’s telephone number 3347939595
Plan sponsor’s address 1245 WESTGATE PARKWAY, DOTHAN, AL, 36303

Plan administrator’s name and address
Administrator’s EIN 630659133
Plan administrator’s name FAMILY PRACTICE CLINIC OF DOTHAN, P
Plan administrator’s address 1245 WESTGATE PARKWAY, DOTHAN, AL, 36303
Administrator’s telephone number 3347939595

Signature of
Role Plan administrator
Date 2012-10-11
Name of individual signing RODDY D COOK
FAMILY PRACTICE CLINIC OF DOTHAN, P.A. PROFIT SHARING PLAN 2010 630659133 2011-10-13 FAMILY PRACTICE CLINIC OF DOTHAN, P.A. 54
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-04-04
Business code 621111
Sponsor’s telephone number 3347939595
Plan sponsor’s address 1245 WESTGATE PARKWAY, DOTHAN, AL, 36303

Plan administrator’s name and address
Administrator’s EIN 630659133
Plan administrator’s name FAMILY PRACTICE CLINIC OF DOTHAN, P
Plan administrator’s address 1245 WESTGATE PARKWAY, DOTHAN, AL, 36303
Administrator’s telephone number 3347939595

Signature of
Role Plan administrator
Date 2011-10-13
Name of individual signing RODDY D COOK
FAMILY PRACTICE CLINIC OF DOTHAN, P.A. PROFIT SHARING PLAN 2009 630659133 2010-10-14 FAMILY PRACTICE CLINIC OF DOTHAN, P.A. 49
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-04-04
Business code 621111
Sponsor’s telephone number 3347939595
Plan sponsor’s address 1245 WESTGATE PARKWAY, DOTHAN, AL, 36303

Plan administrator’s name and address
Administrator’s EIN 630659133
Plan administrator’s name FAMILY PRACTICE CLINIC OF DOTHAN, P
Plan administrator’s address 1245 WESTGATE PARKWAY, DOTHAN, AL, 36303
Administrator’s telephone number 3347939595

Signature of
Role Plan administrator
Date 2010-10-14
Name of individual signing RODDY D COOK

Member

Name Role Address
COOK, RODDY D Member 381 HELMS RDDOTHAN, AL 36301
PAULK, CHARLES T Member 1502 COLGATE CTDOTHAN, AL 36303
O'BRIEN, ROBERT M Member 3411 HUNTINGTON PLDOTHAN, AL 36303
DYESS, LANCE K Member 1668 N CLAXTON AVEELBA, AL 36323

Related by officers

COOK, RODDY D

P&C Auto Sales, Inc.

DYESS, LANCE K

Dove's Nest Enterprises Inc. Dyess Medical Services, Inc.

Related by address

No related companies by address

Date of last update: 30 Jul 2024

Sources: Alabama Secretary of State

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