| Name: | James G. Chambers, III, M.D., P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 01 Oct 1976 (48 years ago) |
| Entity Number: | 000-043-681 |
| Register Number: | 000043681 |
| Place of Formation: | Madison County |
| Principal Address: | HUNTSVILLE, AL |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851601256 | 2010-10-19 | 2010-10-19 | 401 LOWELL DR SE, SUITE 15, HUNTSVILLE, AL, 358013748, US | 401 LOWELL DR SE, SUITE 15, HUNTSVILLE, AL, 358013748, US | |||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 256-534-0659 |
| Fax | 2565342412 |
Authorized person
| Name | DR. JAMES GEORGE CHAMBERS III |
| Role | DOCTOR, PRESIDENT |
| Phone | 2565340659 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 00006818 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS TN. |
| Number | 0114361 |
| State | TN |
| Issuer | BLUE CROSS PROVIDER NUMBER |
| Number | 51001093 |
| State | AL |
| Issuer | RAILROAD MEDICARE PROVIDER |
| Number | P00056562 |
| State | AL |
| Issuer | AETNA PROVIDER NUMBER |
| Number | 0004124418 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CHAMBERS, JAMES G III MD | Incorporator | No data |
| HENRY, GEORGE A III | Incorporator | No data |
| WYNN, JOHN R | Incorporator | 2101 W CLINTON AVENUE SUITE 102HUNTSVILLE, AL 35805 |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
