| Name: | Jefferson - Shelby Surgical Associates, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 04 Jan 1988 (37 years ago) (Companies founded in January 1988) |
| Date of dissolution: | 18 Sep 2019 |
| Entity Number: | 000-121-366 |
| Register Number: | 000121366 |
| Historical Names: |
Salter & Sherer Surgical Associates, P.C.
|
| ZIP code: | 35007 (Companies in Shelby, 35007) |
| County: | Shelby |
| Place of Formation: | Jefferson County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 636 2ND STREET NE SUITE AALABASTER, AL 35007 |
| Authorized Capital: | $5,000 |
Activities
PRACTICE OF MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598839516 | 2006-11-20 | 2016-09-02 | PO BOX 927, ALABASTER, AL, 350072052, US | 636 2ND ST NE, SUITE A, ALABASTER, AL, 350078817, US | |||||||||||||||||||
|
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| Phone | +1 205-663-1180 |
| Fax | 2056631221 |
Authorized person
| Name | DR. BARTON S WOOD |
| Role | OWNER |
| Phone | 2056631180 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE PTAN |
| Number | J343 |
| Name | Role |
|---|---|
| WOOD, BARTON S | Agent |
| Name | Role |
|---|---|
| SALTER, PAUL P III MD | Incorporator |
| SHERER, REX A MD | Incorporator |
| BRACKIN, BRICE MD | Incorporator |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 1994-09-30 | Name Change | Salter & Sherer Surgical Associates, P.C. | Jefferson - Shelby Surgical Associates, P.C. |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
