Name: | Anniston Ear, Nose and Throat, P.C. |
Jurisdiction: | Alabama |
Legal type: | Domestic Professional Corporation |
Status: | Exists |
Date of registration: | 05 Jan 1976 (49 years ago) |
Entity Number: | 000-044-660 |
Register Number: | 000044660 |
Historical Names: |
Anniston Ear, Nose & Throat, P.A.
|
County: | Calhoun |
Place of Formation: | Calhoun County |
Principal Address: | ANNISTON, AL |
Registered Office Street Address: | 901 LEIGHTON AVE STE 601ANNISTON, AL 36207 |
Registered Office Street Address ZIP Code: | 36207 |
Authorized Capital: | $2,000 |
Activities
MEDICAL SERVICES
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1659489615 | 2006-08-29 | 2010-06-29 | 901 LEIGHTON AVE, SUITE 601, ANNISTON, AL, 362075700, US | 901 LEIGHTON AVE, SUITE 601, ANNISTON, AL, 362075700, US | |||||||||||||||||||||||||||
|
Phone | +1 256-236-4426 |
Fax | 2562388830 |
Authorized person
Name | DR. ROBERT H HURLBUTT IV |
Role | PRESIDENT |
Phone | 2562364426 |
Taxonomy
Taxonomy Code | 174400000X - Specialist |
State | AL |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID |
Number | 528601340 |
State | AL |
Issuer | RAILROAD MEDICARE GRP |
Number | CA 0630 |
Name | Role |
---|---|
TOOLE, ARTHUR F III | Agent |
Name | Role |
---|---|
TOOLE, ARTHUR F III MD | Incorporator |
Event Date | Event Type | Old Value | New Value |
---|---|---|---|
1987-09-16 | Name Change | Anniston Ear, Nose & Throat, P.A. | Anniston Ear, Nose and Throat, P.C. |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State