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Marshall Surgical Clinic, P.C.

Details

Name: Marshall Surgical Clinic, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 02 Feb 1994 (31 years ago) (Companies founded in February 1994)
Entity Number: 000-161-949
Register Number: 000161949
ZIP code: 35976 (Companies in Marshall, 35976)
County: Marshall
Place of Formation: Marshall County
Principal Address: GUNTERSVILLE, AL
Registered Office Street Address: 1939 PATTERSON STGUNTERSVILLE, AL 35976
Authorized Capital: $1,000
Paid Share Capital: ----

Activities RENDER PROFESSIONAL MEDICAL SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1154472397 2007-01-15 2012-02-17 2525 US HIGHWAY 431, SUITE 170, BOAZ, AL, 359575934, US 2525 US HIGHWAY 431, SUITE 170, BOAZ, AL, 359575934, US

Contacts
Phone +1 256-593-1611
Fax 2568404596

Authorized person
Name DR. DOUGLAS WAYNE CLINK
Role PRESIDENT
Phone 2565931611

Taxonomy
Taxonomy Code 208600000X - Surgery Physician
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 528800440
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MARSHALL SURGICAL CLINIC, P.C. 401(K) PROFIT SHARING PLAN 2014 631107813 2015-01-12 MARSHALL SURGICAL CLINIC, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 2565825751
Plan sponsor’s address 2525 U.S. HIGHWAY 431, SUITE 170, BOAZ, AL, 35957

Signature of
Role Plan administrator
Date 2015-01-12
Name of individual signing THOMAS W. DOWNES
MARSHALL SURGICAL CLINIC, P.C. 401(K) PROFIT SHARING PLAN 2013 631107813 2014-06-04 MARSHALL SURGICAL CLINIC, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 2565825751
Plan sponsor’s address 2525 U.S. HIGHWAY 431, SUITE 170, BOAZ, AL, 35957

Signature of
Role Plan administrator
Date 2014-06-04
Name of individual signing CRAIG NOLAN
MARSHALL SURGICAL CLINIC, P.C. 401(K) PROFIT SHARING PLAN 2012 631107813 2013-03-29 MARSHALL SURGICAL CLINIC, P.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 2565825751
Plan sponsor’s address 2525 U.S. HIGHWAY 431, SUITE 170, BOAZ, AL, 35957

Signature of
Role Plan administrator
Date 2013-03-29
Name of individual signing CRAIG NOLAN
MARSHALL SURGICAL CLINIC, P.C. 401(K) PROFIT SHARING PLAN 2011 631107813 2012-06-25 MARSHALL SURGICAL CLINIC, P.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 2565825751
Plan sponsor’s mailing address 2525 U.S. HIGHWAY 431, SUITE 170, BOAZ, AL, 35957
Plan sponsor’s address 2525 U.S. HIGHWAY 431, SUITE 170, BOAZ, AL, 35957

Plan administrator’s name and address
Administrator’s EIN 631107813
Plan administrator’s name MARSHALL SURGICAL CLINIC, P.C.
Plan administrator’s address 2525 U.S. HIGHWAY 431, SUITE 170, BOAZ, AL, 35957
Administrator’s telephone number 2565825751

Number of participants as of the end of the plan year
Active participants 9
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 9
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2012-06-25
Name of individual signing CRAIG NOLAN
Valid signature Filed with authorized/valid electronic signature
MARSHALL SURGICAL CLINIC, P.C. 401(K) PROFIT SHARING PLAN 2010 631107813 2011-02-11 MARSHALL SURGICAL CLINIC, P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 2565825751
Plan sponsor’s mailing address 1939 PATTERSON STREET, SUITE 102, GUNTERSVILLE, AL, 359762059
Plan sponsor’s address 1939 PATTERSON STREET, SUITE 102, GUNTERSVILLE, AL, 359762059

Plan administrator’s name and address
Administrator’s EIN 631107813
Plan administrator’s name MARSHALL SURGICAL CLINIC, P.C.
Plan administrator’s address 1939 PATTERSON STREET, SUITE 102, GUNTERSVILLE, AL, 359762059
Administrator’s telephone number 2565825751

Number of participants as of the end of the plan year
Active participants 9
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 9
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2011-02-11
Name of individual signing CRAIG NOLAN
Valid signature Filed with authorized/valid electronic signature
MARSHALL SURGICAL CLINIC, P.C. 401(K) PROFIT SHARING PLAN 2009 631107813 2010-05-20 MARSHALL SURGICAL CLINIC, P.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 2565825751
Plan sponsor’s mailing address 1939 PATTERSON STREET, SUITE 102, GUNTERSVILLE, AL, 359762059
Plan sponsor’s address 1939 PATTERSON STREET, SUITE 102, GUNTERSVILLE, AL, 359762059

Plan administrator’s name and address
Administrator’s EIN 631107813
Plan administrator’s name MARSHALL SURGICAL CLINIC, P.C.
Plan administrator’s address 1939 PATTERSON STREET, SUITE 102, GUNTERSVILLE, AL, 359762059
Administrator’s telephone number 2565825751

Number of participants as of the end of the plan year
Active participants 10
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 10
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2010-05-20
Name of individual signing CRAIG NOLAN
Valid signature Filed with authorized/valid electronic signature
MARSHALL SURGICAL CLINIC, P.C. 401(K) PROFIT SHARING PLAN 2009 631107813 2010-04-10 MARSHALL SURGICAL CLINIC, P.C. 9
Three-digit plan number (PN) 001
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 2565825751
Plan sponsor’s mailing address 1939 PATTERSON STREET, SUITE 102, GUNTERSVILLE, AL, 359762059
Plan sponsor’s address 1939 PATTERSON STREET, SUITE 102, GUNTERSVILLE, AL, 359762059

Plan administrator’s name and address
Administrator’s EIN 631107813
Plan administrator’s name MARSHALL SURGICAL CLINIC, P.C.
Plan administrator’s address 1939 PATTERSON STREET, SUITE 102, GUNTERSVILLE, AL, 359762059
Administrator’s telephone number 2565825751

Number of participants as of the end of the plan year
Active participants 10
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 10
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role DFE
Date 2010-04-10
Name of individual signing CRAIG NOLAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
CLINK, DOUGLAS MD Agent

Incorporator

Name Role
CLINK, DOUGLAS MD Incorporator
DOWNES, THOMAS MD Incorporator

Related by officers

No related officers

Related by address

GUNTERSVILLE, AL

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Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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