| Name: | Eye Care Associates of the Southeast, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 10 Dec 1985 (39 years ago) |
| Entity Number: | 000-107-544 |
| Register Number: | 000107544 |
| Historical Names: |
Total Eye Care, P.C.
|
| County: | Houston |
| Place of Formation: | Houston County |
| Principal Address: | DOTHAN, AL |
| Registered Office Street Address: | 2815-B ROSS CLARK CIRCLE SWDOTHAN, AL 36301 |
| Registered Office Street Address ZIP Code: | 36301 |
| Authorized Capital: | $1,000 |
Activities
OPTOMETRY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1689768038 | 2006-10-02 | 2008-11-05 | PO BOX 1846, DOTHAN, AL, 363021846, US | 111 W MAIN ST, DOTHAN, AL, 36301, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 334-794-1175 |
| Fax | 3347930619 |
Authorized person
| Name | DR. WILLIAM HEATH FEAGIN |
| Role | PRESIDENT |
| Phone | 3347941175 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | S-429-TA-034 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000059835 |
| State | AL |
| Issuer | RAILROAD MEDICARE |
| Number | 410022118 |
| State | AL |
| Issuer | BCBS OF ALABAMA |
| Number | 59835 |
| State | AL |
| Name | Role |
|---|---|
| FEAGIN, WILLIAM H DR | Agent |
| Name | Role |
|---|---|
| FEAGIN, WILLIAM H DR | Incorporator |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 1986-11-06 | Name Change | Total Eye Care, P.C. | Eye Care Associates of the Southeast, P.C. |
Date of last update: 31 Jul 2024
Sources: Alabama Secretary of State
