| 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
