| Name: | E. Earl Walker, M. D., P. C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 30 Jun 1980 (44 years ago) |
| Entity Number: | 000-061-908 |
| Register Number: | 000061908 |
| County: | Lauderdale |
| Place of Formation: | Lauderdale County |
| Principal Address: | FLORENCE, AL |
| Registered Office Street Address: | 2415 HELTON DRFLORENCE, AL 35630 |
| Registered Office Street Address ZIP Code: | 35630 |
| Authorized Capital: | $2,000 |
| Paid Share Capital: | $1,000 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750472015 | 2006-09-28 | 2008-02-04 | 2415 HELTON DR STE B, FLORENCE, AL, 356301067, US | 2415 HELTON DR STE B, FLORENCE, AL, 356301067, US | |||||||||||||||||||||||||
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| Phone | +1 256-766-8550 |
| Fax | 2567668002 |
Authorized person
| Name | MRS. BELINDA F. GARGIS |
| Role | INSURANCE/BILLING/CODING |
| Phone | 2567668550 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | 7886 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS OF ALABAMA |
| Number | 05747 |
| State | AL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| E. EARL WALKER, M.D., P.C. PROFIT SHARING PLAN | 2014 | 630791156 | 2015-03-25 | E. EARL WALKER, M.D., P.C. | 10 | |||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2015-03-25 |
| Name of individual signing | E EARL WALKER, M.D. |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1981-07-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2567668550 |
| Plan sponsor’s address | 2415 HELTON DRIVE STE B, FLORENCE, AL, 35630 |
Signature of
| Role | Plan administrator |
| Date | 2014-08-28 |
| Name of individual signing | E EARL WALKER, M.D. |
| Name | Role | Address |
|---|---|---|
| WALKER, EDWARD EARL MD | Incorporator | No data |
| RUTLEDGE, WAYNE D | Incorporator | No data |
| MONCUS, CLAUDE MCCAIN | Incorporator | 2616 HEATHERMOOR ROADBIRMINGHAM, AL 35223 |
| Name | Role |
|---|---|
| WALKER, E EARL MD | Agent |
Date of last update: 31 Jul 2024
Sources: Alabama Secretary of State
