| Name: | Avalon Surgical, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 03 Jun 1980 (44 years ago) |
| Date of dissolution: | 13 May 2014 |
| Entity Number: | 000-061-447 |
| Register Number: | 000061447 |
| Historical Names: |
Drs. Copeland & McKinley, P.C.
David P. McKinley, M.D., P.C. |
| Place of Formation: | Colbert County |
| Principal Address: | SHEFFIELD, AL |
| Authorized Capital: | $5,000 |
| Paid Share Capital: | $5,000 |
Activities
MEDICAL
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790955920 | 2008-03-04 | 2013-07-16 | PO BOX 298, SHEFFIELD, AL, 356600298, US | 1120 S JACKSON HWY STE 307, SHEFFIELD, AL, 356605773, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 256-381-0030 |
| Fax | 2563830764 |
Authorized person
| Name | DR. DAVID PARKS MCKINLEY |
| Role | PRESIDENT |
| Phone | 2563810030 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| License Number | 5762 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | METRAHEALTH/RAILROAD |
| Number | DD6002 |
| State | AL |
| Issuer | FIRSTCOMMUNITY |
| Number | 00780 |
| State | AL |
| Issuer | MEDICAID |
| Number | 529926920 |
| State | AL |
| Issuer | CAQH |
| Number | 10912029 |
| State | AL |
| Issuer | UNITEDHEALTHCARE |
| Number | 17-00656 |
| State | AL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AVALON SURGICAL, P.C. PROFIT SHARING PLAN | 2013 | 630789637 | 2014-03-29 | AVALON SURGICAL, P.C. | 3 | |||||||||||||||||||||
|
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| Role | Plan administrator |
| Date | 2014-03-29 |
| Name of individual signing | DAVID P. MCKINLEY, M.D. |
| Name | Role |
|---|---|
| MCKINLEY, DAVID P | Incorporator |
| COPELAND, KENNETH R | Incorporator |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 1991-01-22 | Name Change | David P. McKinley, M.D., P.C. | Avalon Surgical, P.C. |
| 1990-07-05 | Name Change | Drs. Copeland & McKinley, P.C. | David P. McKinley, M.D., P.C. |
Date of last update: 31 Jul 2024
Sources: Alabama Secretary of State
