| Name: | Feagin and Owen, M.D., P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 02 Oct 1984 (40 years ago) |
| Entity Number: | 000-100-296 |
| Register Number: | 000100296 |
| Historical Names: |
Charles A. Feagin, M.D., P.C.
Feagin, Owen & Baker, P.C. |
| County: | Houston |
| Place of Formation: | Houston County |
| Registered Office Street Address: | 4300 WEST MAIN STREET STE 43DOTHAN, AL 36305 |
| Registered Office Street Address ZIP Code: | 36305 |
| Authorized Capital: | $1,000 |
Activities
MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346490604 | 2008-09-23 | 2008-10-09 | 4300 W MAIN ST, SUITE 43, DOTHAN, AL, 363051054, US | 4300 W MAIN ST, SUITE 43, DOTHAN, AL, 363051054, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 334-793-7211 |
| Fax | 3347935425 |
Authorized person
| Name | KIMBERLY C BYRD |
| Role | INSURANCE |
| Phone | 3347937211 |
Taxonomy
| Taxonomy Code | 261QM2500X - Medical Specialty Clinic/Center |
| License Number | 7921 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 261QM2500X - Medical Specialty Clinic/Center |
| License Number | 13944 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000011782 |
| State | AL |
| Issuer | MEDICAID |
| Number | 000082133 |
| State | AL |
| Issuer | INDIVIDUAL NPI FOR DR. CHARLES FEAGIN |
| Number | 1427141282 |
| State | AL |
| Issuer | INDIVIDUAL NPI FOR DR. WILLIAM I. OWEN |
| Number | 1619062064 |
| State | AL |
| Issuer | BCBS OF ALABAMA PROVIDER NUMBER -- CHARLES FEAGIN, M.D. |
| Number | 11782 |
| State | AL |
| Issuer | BCBS OF ALABAMA PROVIDER FOR DR. WILLIAM I. OWEN, JR |
| Number | 82133 |
| State | AL |
| Issuer | ALABAMA MEDICAID PAYEE ID: 529001560 |
| Number | 529001560 |
| State | AL |
| Name | Role |
|---|---|
| SMITH, YVETTE | Agent |
| Name | Role |
|---|---|
| FEAGIN, CHARLES A JR MD | Incorporator |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2013-07-09 | Name Change | Feagin, Owen & Baker, P.C. | Feagin and Owen, M.D., P.C. |
| 1994-12-20 | Name Change | Charles A. Feagin, M.D., P.C. | Feagin, Owen & Baker, P.C. |
Date of last update: 31 Jul 2024
Sources: Alabama Secretary of State
