| Name: | ANDALUSIA NEUROLOGY, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 24 Jul 2012 (12 years ago) |
| Entity Number: | 000-071-887 |
| Register Number: | 000071887 |
| County: | Covington |
| Place of Formation: | Covington County |
| Registered Office Street Address: | 109 MEDICAL PARK DRIVE SUITE AANDALUSIA, AL 36420 |
| Registered Office Street Address ZIP Code: | 36420 |
| Authorized Capital: | 2000 @ $1.00PV |
Activities
PRACTICE OF NEUROLOGY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871841171 | 2012-08-17 | 2012-08-17 | 109 MEDICAL PARK DR, SUITE A, ANDALUSIA, AL, 364205323, US | 109 MEDICAL PARK DR, SUITE A, ANDALUSIA, AL, 364205323, US | |||||||||||||||||||||||||
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| Phone | +1 334-222-3222 |
| Fax | 3342223224 |
Authorized person
| Name | SADIK YESIL |
| Role | PRESIDENT |
| Phone | 3342223222 |
Taxonomy
| Taxonomy Code | 2084N0400X - Neurology Physician |
| License Number | 31786 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | PENDING |
| State | AL |
| Name | Role | Address |
|---|---|---|
| YESIL, SADIK | Agent | 109 MEDICAL PARK DRIVE SUITE AANDALUSIA, AL 36420 |
| Name | Role | Address |
|---|---|---|
| YESIL, SADIK | Director | 109 MEDICAL PARK DRIVE SUITE AANDALUSIA, AL 36420 |
| Name | Role | Address |
|---|---|---|
| ALBRITTON, THOMAS B | Incorporator | 109 OPP AVENUEANDALUSIA, AL 36420 |
Date of last update: 31 Jul 2024
Sources: Alabama Secretary of State
