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Dothan Neurodiagnostic Center, P.C.

Details

Name: Dothan Neurodiagnostic Center, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 07 Mar 1984 (41 years ago)
Entity Number: 000-096-804
Register Number: 000096804
County: Houston
Place of Formation: Houston County
Registered Office Street Address: 1520 EAST MAIN ST SUITE 3DOTHAN, AL 36301
Registered Office Street Address ZIP Code: 36301
Authorized Capital: $1,000

Activities MEDICAL SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1043463557 2008-10-28 2008-10-28 1800 FAIRVIEW AVE, SUITE 1, DOTHAN, AL, 363013058, US 1800 FAIRVIEW AVE, SUITE 1, DOTHAN, AL, 363013058, US

Contacts
Phone +1 334-793-1703
Fax 3347939314

Authorized person
Name ALAN D PRINCE
Role OWNER
Phone 3347931703

Taxonomy
Taxonomy Code 2084N0400X - Neurology Physician
License Number 11321
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DOTHAN NEURODIAGNOSTIC CENTER, P.C. PROFIT SHARING PLAN 2013 630869365 2014-02-27 DOTHAN NEURODIAGNOSTIC CENTER, P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-03-01
Business code 621111
Sponsor’s telephone number 3343474255
Plan sponsor’s mailing address 806 GLOVER AVE., SUITE B, ENTERPRISE, AL, 36330
Plan sponsor’s address 806 GLOVER AVE., SUITE B, ENTERPRISE, AL, 36330

Number of participants as of the end of the plan year
Active participants 2
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 2
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0
DOTHAN NEURODIAGNOSTIC CENTER, P.C. PROFIT SHARING PLAN 2012 630869365 2013-08-06 DOTHAN NEURODIAGNOSTIC CENTER, P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-03-01
Business code 621111
Sponsor’s telephone number 3343474255
Plan sponsor’s mailing address 806 GLOVER AVE., SUITE B, ENTERPRISE, AL, 36330
Plan sponsor’s address 806 GLOVER AVE., SUITE B, ENTERPRISE, AL, 36330

Number of participants as of the end of the plan year
Active participants 2
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 1
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 3
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 1

Signature of
Role Plan administrator
Date 2013-08-06
Name of individual signing ALAN PRINCE, MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-08-06
Name of individual signing ALAN PRINCE, MD
Valid signature Filed with authorized/valid electronic signature
DOTHAN NEURODIAGNOSTIC CENTER, P.C. PROFIT SHARING PLAN 2011 630869365 2012-05-24 DOTHAN NEURODIAGNOSTIC CENTER, P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-03-01
Business code 621111
Sponsor’s telephone number 2057931703
Plan sponsor’s mailing address 1800 FAIRVIEW AVENUE, SUITE 1, DOTHAN, AL, 363013026
Plan sponsor’s address 1800 FAIRVIEW AVENUE, SUITE 1, DOTAN, AL, 36301

Plan administrator’s name and address
Administrator’s EIN 630869365
Plan administrator’s name DOTHAN NEURODIAGNOSTIC CENTER, P.C.
Plan administrator’s address 1800 FAIRVIEW AVENUE, SUITE 1, DOTHAN, AL, 363013026
Administrator’s telephone number 2057931703

Number of participants as of the end of the plan year
Active participants 3
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 1
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 4
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2012-05-24
Name of individual signing ALAN PRINCE, MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-05-24
Name of individual signing ALAN PRINCE, MD
Valid signature Filed with authorized/valid electronic signature
DOTHAN NEURODIAGNOSTIC CENTER, P.C. PROFIT SHARING PLAN 2010 630869365 2011-09-29 DOTHAN NEURODIAGNOSTIC CENTER, P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-03-01
Business code 621111
Sponsor’s telephone number 2057931703
Plan sponsor’s mailing address 1800 FAIRVIEW AVE, STE A, DOTHAN, AL, 363013026
Plan sponsor’s address 1800 FAIRVIEW AVENUE, STE A, DOTHA, AL, 363013026

Plan administrator’s name and address
Administrator’s EIN 630869365
Plan administrator’s name DOTHAN NEURODIAGNOSTIC CENTER, P.C.
Plan administrator’s address 1800 FAIRVIEW AVE, STE A, DOTHAN, AL, 363013026
Administrator’s telephone number 2057931703

Number of participants as of the end of the plan year
Active participants 4
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 4
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2011-09-29
Name of individual signing ALAN D. PRINCE, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-09-29
Name of individual signing ALAN D. PRINCE, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
PRINCE, ALAN D MD Agent

Incorporator

Name Role
PRINCE, ALAN D MD Incorporator

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 31 Jul 2024

Sources: Alabama Secretary of State

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