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 | |||||||||||||||||||||||||
|
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 | |||||||||||||||||||||
|
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