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Internal Medicine Associates of Dothan, P.A.

Details

Name: Internal Medicine Associates of Dothan, P.A.
Jurisdiction: Alabama
Legal type: Domestic Professional Association
Status: Dissolved
Date of registration: 22 Apr 1982 (43 years ago)
Date of dissolution: 27 Dec 2018
Entity Number: 000-064-614
Register Number: 000064614
County: Houston
Place of Formation: Houston County
Principal Address: 509 W MAIN STREETDOTHAN, AL 36301
Principal Address ZIP Code: 36301

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1336196682 2006-05-30 2009-12-16 210 WESTSIDE DR, DOTHAN, AL, 363031928, US 210 WESTSIDE DR, DOTHAN, AL, 363031928, US

Contacts
Phone +1 334-793-5074
Fax 3347936460

Authorized person
Name MR. GEORGE WAKEFIELD
Role ADMINISTRATOR
Phone 3347935074

Taxonomy
Taxonomy Code 207R00000X - Internal Medicine Physician
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 529302970
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
INTERNAL MEDICINE ASSOCIATES OF DOTHAN 401(K) PROFIT SHARING PLAN 2019 630825084 2020-01-29 INTERNAL MEDICINE ASSOCIATES OF DOTHAN, P.A. 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1982-04-01
Business code 621111
Sponsor’s telephone number 3347935074
Plan sponsor’s address 210 WESTSIDE DRIVE, DOTHAN, AL, 36303
INTERNAL MEDICINE ASSOCIATES OF DOTHAN 401(K) PROFIT SHARING PLAN 2018 630825084 2019-08-19 INTERNAL MEDICINE ASSOCIATES OF DOTHAN, P.A. 46
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1982-04-01
Business code 621111
Sponsor’s telephone number 3347935074
Plan sponsor’s address 210 WESTSIDE DRIVE, DOTHAN, AL, 36303
INTERNAL MEDICINE ASSOCIATES OF DOTHAN 401(K) PROFIT SHARING PLAN 2017 630825084 2018-06-21 INTERNAL MEDICINE ASSOCIATES OF DOTHAN, P.A. 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1982-04-01
Business code 621111
Sponsor’s telephone number 3347935074
Plan sponsor’s address 210 WESTSIDE DRIVE, DOTHAN, AL, 36303

Signature of
Role Plan administrator
Date 2018-06-21
Name of individual signing CALVIN REID
Role Employer/plan sponsor
Date 2018-06-21
Name of individual signing CALVIN REID
INTERNAL MEDICINE ASSOCIATES OF DOTHAN 401(K) PROFIT SHARING PLAN 2016 630825084 2017-04-24 INTERNAL MEDICINE ASSOCIATES OF DOTHAN, P.A. 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1982-04-01
Business code 621111
Sponsor’s telephone number 3347935074
Plan sponsor’s address 210 WESTSIDE DRIVE, DOTHAN, AL, 36303
INTERNAL MEDICINE ASSOCIATES OF DOTHAN 401(K) PROFIT SHARING PLAN 2015 630825084 2016-07-07 INTERNAL MEDICINE ASSOCIATES OF DOTHAN, P.A. 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1982-04-01
Business code 621111
Sponsor’s telephone number 3347935074
Plan sponsor’s address 210 WESTSIDE DRIVE, DOTHAN, AL, 36303

Signature of
Role Plan administrator
Date 2016-07-07
Name of individual signing CALVIN REID
Role Employer/plan sponsor
Date 2016-07-07
Name of individual signing CALVIN REID
INTERNAL MEDICINE ASSOCIATES OF DOTHAN 401(K) PROFIT SHARING PLAN 2014 630825084 2015-05-12 INTERNAL MEDICINE ASSOCIATES OF DOTHAN, P.A. 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1982-04-01
Business code 621111
Sponsor’s telephone number 3347935074
Plan sponsor’s address 210 WESTSIDE DRIVE, DOTHAN, AL, 36303

Signature of
Role Plan administrator
Date 2015-05-12
Name of individual signing CALVIN REID
Role Employer/plan sponsor
Date 2015-05-12
Name of individual signing CALVIN REID
INTERNAL MEDICINE ASSOCIATES OF DOTHAN 401(K) PROFIT SHARING PLAN 2014 630825084 2015-04-07 INTERNAL MEDICINE ASSOCIATES OF DOTHAN, P.A. 40
Three-digit plan number (PN) 001
Effective date of plan 1982-04-01
Business code 621111
Sponsor’s telephone number 3347935074
Plan sponsor’s address 210 WESTSIDE DRIVE, DOTHAN, AL, 36303

Signature of
Role Plan administrator
Date 2015-04-07
Name of individual signing CALVIN REID
Role Employer/plan sponsor
Date 2015-04-07
Name of individual signing CALVIN REID
INTERNAL MEDICINE ASSOCIATES OF DOTHAN 401(K) PROFIT SHARING PLAN 2013 630825084 2014-04-01 INTERNAL MEDICINE ASSOCIATES OF DOTHAN, P.A. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1982-04-01
Business code 621111
Sponsor’s telephone number 3347935074
Plan sponsor’s address 210 WESTSIDE DRIVE, DOTHAN, AL, 36303

Signature of
Role Plan administrator
Date 2014-04-01
Name of individual signing CALVIN REID
Role Employer/plan sponsor
Date 2014-04-01
Name of individual signing CALVIN REID
INTERNAL MEDICINE ASSOCIATES OF DOTHAN 401(K) PROFIT SHARING PLAN 2012 630825084 2013-04-05 INTERNAL MEDICINE ASSOCIATES OF DOTHAN, P.A. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1982-04-01
Business code 621111
Sponsor’s telephone number 3347935074
Plan sponsor’s address 210 WESTSIDE DRIVE, DOTHAN, AL, 36303

Signature of
Role Plan administrator
Date 2013-04-04
Name of individual signing CALVIN L. REID MD
Role Employer/plan sponsor
Date 2013-04-04
Name of individual signing CALVIN L. REID MD
INTERNAL MEDICINE ASSOCIATES OF DOTHAN 401(K) PROFIT SHARING PLAN 2011 630825084 2012-02-07 INTERNAL MEDICINE ASSOCIATES OF DOTHAN, P.A. 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1982-04-01
Business code 621111
Sponsor’s telephone number 3347935074
Plan sponsor’s address 210 WESTSIDE DRIVE, DOTHAN, AL, 36303

Plan administrator’s name and address
Administrator’s EIN 630825084
Plan administrator’s name INTERNAL MEDICINE ASSOCIATES OF DOTHAN, P.A.
Plan administrator’s address 210 WESTSIDE DRIVE, DOTHAN, AL, 36303
Administrator’s telephone number 3347935074

Signature of
Role Plan administrator
Date 2012-02-07
Name of individual signing CALVIN REID
Role Employer/plan sponsor
Date 2012-02-07
Name of individual signing CALVIN REID

Member

Name Role
WEST, LEWE SESSIONS MD Member
GORDON, LLOYD J III MD Member
FINCHER, ROBERT JEROME MD Member

Related by officers

No related officers

Related by address

509 W MAIN STREETDOTHAN, AL 36301

Dr. Press Thornton, P.A. Ronald K. Randall, M.D., P.A.

Date of last update: 31 Jul 2024

Sources: Alabama Secretary of State

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