Search icon

Fowler Sports Medicine and Orthopaedics, P.C.

Details

Name: Fowler Sports Medicine and Orthopaedics, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Dissolved
Date of registration: 29 Feb 1988 (37 years ago)
Date of dissolution: 18 Apr 2011
Entity Number: 000-122-519
Register Number: 000122519
Historical Names: H. Leslie Fowler, M.D., P.C.
Place of Formation: Tuscaloosa County
Principal Address: TUSCALOOSA, AL
Registered Office Street Address: 600 UNIVERSITY BLVDTUSCALOOSA, AL
Authorized Capital: $5,000

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1366407199 2006-04-17 2009-03-17 100 RICE MINE ROAD LOOP, SUITE 205, TUSCALOOSA, AL, 354062419, US 100 RICE MINE ROAD LOOP, SUITE 205, TUSCALOOSA, AL, 354062419, US

Contacts

Phone +1 205-752-1800
Fax 2057521891

Authorized person

Name DR. HOWARD LESLIE FOWLER
Role PRESIDENT
Phone 2057521800

Taxonomy

Taxonomy Code 207X00000X - Orthopaedic Surgery Physician
Is Primary Yes
Taxonomy Code 332B00000X - Durable Medical Equipment & Medical Supplies
Is Primary No

Other Provider Identifiers

Issuer MEDICAID
Number 529002300
State AL

Agent

Name Role
FOWLER, H LESLIE MD Agent

Incorporator

Name Role
FOWLER, H LESLIE MD Incorporator

Events

Event Date Event Type Old Value New Value
1990-05-17 Name Change H. Leslie Fowler, M.D., P.C. Fowler Sports Medicine and Orthopaedics, P.C.

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State