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Wiregrass Surgical Associates, P.C.

Details

Name: Wiregrass Surgical Associates, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 02 Jan 1991 (34 years ago)
Entity Number: 000-140-911
Register Number: 000140911
Historical Names: Conner, Moore & Fendley, P.C.
County: Houston
Place of Formation: Houston County
Registered Office Street Address: 4300 WEST MAIN STREET SUITE 24DOTHAN, AL 36303
Registered Office Street Address ZIP Code: 36303
Authorized Capital: $2,000
Paid Share Capital: $1,002

Activities MEDICINE AND GENERAL SURGERY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1750387833 2005-06-23 2020-08-22 1118 ROSS CLARK CIR, STE 310, DOTHAN, AL, 363013002, US 1118 ROSS CLARK CIR, STE 310, DOTHAN, AL, 363013002, US

Contacts
Phone +1 334-793-1534
Fax 3347936991

Authorized person
Name DR. STEVEN M. FENDLEY
Role PRESIDENT
Phone 3347931534

Taxonomy
Taxonomy Code 208600000X - Surgery Physician
License Number 0074230
State AL
Is Primary No
Taxonomy Code 2086S0129X - Vascular Surgery Physician
License Number 0074230
State AL
Is Primary No

Other Provider Identifiers
Issuer PHCS GROUP ID #
Number 000003047248
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
WIREGRASS SURGICAL ASSOCIATES, P.C. PROFIT SHARING PLAN 2023 631037212 2024-07-23 WIREGRASS SURGICAL ASSOCIATES, P.C. 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-01-01
Business code 621111
Sponsor’s telephone number 3347931534
Plan sponsor’s address 4300 WEST MAIN STREET, SUITE 24, DOTHAN, AL, 36301
WIREGRASS SURGICAL ASSOCIATES, P.C. PROFIT SHARING PLAN 2022 631037212 2023-04-20 WIREGRASS SURGICAL ASSOCIATES, P.C. 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-01-01
Business code 621111
Sponsor’s telephone number 3347931534
Plan sponsor’s address 4300 WEST MAIN STREET, SUITE 24, DOTHAN, AL, 36301
WIREGRASS SURGICAL ASSOCIATES, P.C. PROFIT SHARING PLAN 2022 631037212 2023-04-20 WIREGRASS SURGICAL ASSOCIATES, P.C. 31
Three-digit plan number (PN) 001
Effective date of plan 1984-01-01
Business code 621111
Sponsor’s telephone number 3347931534
Plan sponsor’s address 4300 WEST MAIN STREET, SUITE 24, DOTHAN, AL, 36301
WIREGRASS SURGICAL ASSOCIATES, P.C. PROFIT SHARING PLAN 2021 631037212 2022-02-23 WIREGRASS SURGICAL ASSOCIATES, P.C. 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-01-01
Business code 621111
Sponsor’s telephone number 3347931534
Plan sponsor’s address 4300 WEST MAIN STREET, SUITE 24, DOTHAN, AL, 36301
WIREGRASS SURGICAL ASSOCIATES, P.C. PROFIT SHARING PLAN 2020 631037212 2021-04-13 WIREGRASS SURGICAL ASSOCIATES, P.C. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-01-01
Business code 621111
Sponsor’s telephone number 3347931534
Plan sponsor’s address 4300 WEST MAIN STREET, SUITE 24, DOTHAN, AL, 36301
WIREGRASS SURGICAL ASSOCIATES, P.C. PROFIT SHARING PLAN 2019 631037212 2020-05-26 WIREGRASS SURGICAL ASSOCIATES, P.C. 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-01-01
Business code 621111
Sponsor’s telephone number 3347931534
Plan sponsor’s address 1118 ROSS CLARK CIRCLE, SUITE 310, DOTHAN, AL, 36301
WIREGRASS SURGICAL ASSOCIATES, P.C. PROFIT SHARING PLAN 2018 631037212 2019-03-22 WIREGRASS SURGICAL ASSOCIATES, P.C. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-01-01
Business code 621111
Sponsor’s telephone number 3347931534
Plan sponsor’s address 1118 ROSS CLARK CIRCLE, SUITE 310, DOTHAN, AL, 36301
WIREGRASS SURGICAL ASSOCIATES, P.C. PROFIT SHARING PLAN 2017 631037212 2018-10-15 WIREGRASS SURGICAL ASSOCIATES, P.C. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-01-01
Business code 621111
Sponsor’s telephone number 3347931534
Plan sponsor’s address 1118 ROSS CLARK CIRCLE, SUITE 310, DOTHAN, AL, 36301

Agent

Name Role Address
FENDLEY, STEVEN M Agent 4300 WEST MAIN STREET SUITE 24DOTHAN, AL 36305

Director

Name Role Address
FENDLEY, STEVEN M Director 4300 WEST MAIN STREET SUITE 24DOTHAN, AL 36305
ROBBINS, SCOTT G Director 4300 WEST MAIN STREET SUITE 24DOTHAN, AL 36303
PFEIFFER, RALPH B III Director 4300 WEST MAIN STREET SUITE 24DOTHAN, AL 36305

Incorporator

Name Role Address
CONNER, CHARLES F Incorporator No data
MOORE, JOHN P JR Incorporator No data
FENDLEY, STEVEN M Incorporator 4300 WEST MAIN STREET SUITE 24DOTHAN, AL 36305

Events

Event Date Event Type Old Value New Value
1995-05-18 Name Change Conner, Moore & Fendley, P.C. Wiregrass Surgical Associates, P.C.

Related by officers

FENDLEY, STEVEN M

OperationServe WSA Realty, LLC WSA Investments, L.L.C.

PFEIFFER, RALPH B III

WSA Investments, L.L.C.

MOORE, JOHN P JR

Moore Development Company LLC

Related by address

No related companies by address

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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