| Name: | Cottage Hill Podiatry Group, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 04 Aug 1992 (32 years ago) |
| Entity Number: | 000-151-248 |
| Register Number: | 000151248 |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Principal Address: | MOBILE, AL |
| Registered Office Street Address: | 4266 COTTAGE HILL ROADMOBILE, AL 36609 |
| Registered Office Street Address ZIP Code: | 36609 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
Activities
PODIATRY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861569923 | 2006-11-30 | 2011-01-18 | 1371 MONTLIMAR DR, MOBILE, AL, 366091645, US | 1371 MONTLIMAR DR, MOBILE, AL, 366091645, US | |||||||||||||||||||||||||
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| Phone | +1 251-304-0804 |
| Fax | 2513040806 |
Authorized person
| Name | DR. ELLIOT JAY BRAUN |
| Role | PRESIDENT |
| Phone | 2513040804 |
Taxonomy
| Taxonomy Code | 213ES0131X - Foot Surgery Podiatrist |
| License Number | 0064 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS |
| Number | 70437 |
| State | AL |
| Name | Role |
|---|---|
| BRAUN, ELLIOT J | Agent |
| Name | Role |
|---|---|
| BRAUN, ELLIOT J | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
