| Name: | Talladega OB-GYN Associates, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 01 Jul 1975 (49 years ago) |
| Date of dissolution: | 31 Dec 2014 |
| Entity Number: | 000-038-519 |
| Register Number: | 000038519 |
| Historical Names: |
Talladega OB-GYN Associates, P.A.
|
| County: | Talladega |
| Place of Formation: | Talladega County |
| Principal Address: | TALLADEGA, AL |
| Registered Office Street Address: | 202 MEDICAL OFFICE PARKTALLADEGA, AL 35160 |
| Registered Office Street Address ZIP Code: | 35160 |
| Authorized Capital: | $5,000 |
Activities
MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366471567 | 2006-07-01 | 2014-01-21 | 724 STONE AVE, TALLADEGA, AL, 351602219, US | 724 STONE AVE, TALLADEGA, AL, 351602219, US | |||||||||||||||||||||||
|
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| Phone | +1 256-362-1410 |
| Fax | 2563620186 |
Authorized person
| Name | DR. H BYRON PHILLIPS |
| Role | PRESIDENT |
| Phone | 2563621410 |
Taxonomy
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529002280 |
| State | AL |
| Name | Role |
|---|---|
| GURLEY, JERRY N MD | Agent |
| Name | Role |
|---|---|
| GURLEY, JERRY N MD | Incorporator |
| PHILLIPS, H BYRON JR MD | Incorporator |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 1984-10-24 | Name Change | Talladega OB-GYN Associates, P.A. | Talladega OB-GYN Associates, P.C. |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
