| Name: | Marcia J. Littles, M.D., P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 10 Jul 1990 (34 years ago) |
| Date of dissolution: | 29 Dec 2016 |
| Entity Number: | 000-138-031 |
| Register Number: | 000138031 |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Registered Office Street Address: | 3401 MEDICAL PARK DRIVE BLDG 3, SUITE 104MOBILE, AL 36693 |
| Registered Office Street Address ZIP Code: | 36693 |
| Authorized Capital: | $1,000 |
Activities
PRACTICE MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235285511 | 2007-01-26 | 2010-03-12 | PO BOX 851387, MOBILE, AL, 366851387, US | 6701 AIRPORT BLVD, SUITE D100, MOBILE, AL, 366086705, US | |||||||||||||||||||||||||||
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| Phone | +1 251-366-3662 |
| Fax | 2516333660 |
| Phone | +1 251-633-6332 |
Authorized person
| Name | MARCIA J LITTLES |
| Role | CEO |
| Phone | 2516333662 |
Taxonomy
| Taxonomy Code | 207RG0300X - Geriatric Medicine (Internal Medicine) Physician |
| License Number | 12672 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529932808 |
| State | AL |
| Name | Role |
|---|---|
| LITTLES, MARCIA J MD | Agent |
| Name | Role |
|---|---|
| COYLE, J TIM | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
