| Name: | West Alabama Family Physicians, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 06 Jul 1989 (35 years ago) |
| Date of dissolution: | 23 Dec 2015 |
| Entity Number: | 000-131-805 |
| Register Number: | 000131805 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Principal Address: | NORTHPORT, AL |
| Registered Office Street Address: | 15643 COMPASS DRNORTHPORT, AL 35475 |
| Registered Office Street Address ZIP Code: | 35475 |
| Authorized Capital: | $1,000 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447262977 | 2006-08-13 | 2020-08-22 | 2330 UNIVERSITY BLVD, SUITE 501, TUSCALOOSA, AL, 354011599, US | 1251 MCFARLAND BLVD NE, TUSCALOOSA, AL, 354062205, US | |||||||||||||||||||||||
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| Phone | +1 205-344-9021 |
| Fax | 2053449031 |
| Phone | +1 205-349-2323 |
| Fax | 2053491155 |
Authorized person
| Name | MR. DERICK MORRING BEEM |
| Role | ADMINISTRATOR |
| Phone | 2053449019 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 221475 |
| State | AL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WEST ALABAMA FAMILY PHYSICIANS, P.C. PROFIT SHARING PLAN | 2014 | 631004988 | 2015-03-17 | WEST ALABAMA FAMILY PHYSICIANS, P.C. | 32 | |||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2015-03-17 |
| Name of individual signing | JOHN NEWCOMB |
| Name | Role |
|---|---|
| NEWCOMB, JOHN | Agent |
| Name | Role |
|---|---|
| WILLIAMSON, NATHAN MD | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
