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Cancer Surgery of Mobile, P.C.

Details

Name: Cancer Surgery of Mobile, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Dissolved
Date of registration: 10 Jun 1994 (30 years ago) (Companies founded in June 1994)
Date of dissolution: 16 Jan 2013
Entity Number: 000-164-739
Register Number: 000164739
ZIP code: 36607 (Companies in Mobile, 36607)
County: Mobile
Place of Formation: Mobile County
Principal Address: MOBILE, AL
Registered Office Street Address: 3 MOBILE INFIRMARY CR STE 305MOBILE, AL 36607
Authorized Capital: $1,000
Paid Share Capital: ----

Activities CONDUCT THE PRIVATE PRACTICE OF MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1376690339 2007-01-04 2020-08-22 3 MOBILE INFIRMARY CIR, STE 305, MOBILE, AL, 366073520, US 3 MOBILE INFIRMARY CIR, STE 305, MOBILE, AL, 366073520, US

Contacts

Phone +1 251-433-5557
Fax 2514335558

Authorized person

Name DR. LEE WALTON THOMPSON
Role PHYSICIAN
Phone 2514335557

Taxonomy

Taxonomy Code 2086X0206X - Surgical Oncology Physician
License Number 24560
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CANCER SURGERY OF MOBILE, P.C. PROFIT SHARING PLAN 2011 631120875 2012-10-12 CANCER SURGERY OF MOBILE, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-07-01
Business code 621111
Sponsor’s telephone number 2514335557
Plan sponsor’s address 3 MOBILE INFIRMARY CIRCLE SUITE 305, MOBILE, AL, 366073515

Plan administrator’s name and address

Administrator’s EIN 631120875
Plan administrator’s name CANCER SURGERY OF MOBILE, P.C.
Plan administrator’s address 3 MOBILE INFIRMARY CIRCLE SUITE 305, MOBILE, AL, 366073515
Administrator’s telephone number 2514335557

Signature of

Role Plan administrator
Date 2012-10-12
Name of individual signing DR. LEE THOMPSON
CANCER SURGERY OF MOBILE, P.C. PROFIT SHARING PLAN 2010 631120875 2011-07-13 CANCER SURGERY OF MOBILE, P.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-07-01
Business code 621111
Sponsor’s telephone number 2514335557
Plan sponsor’s address 3 MOBILE INFIRMARY CIRCLE SUITE 305, MOBILE, AL, 366073515

Plan administrator’s name and address

Administrator’s EIN 631120875
Plan administrator’s name CANCER SURGERY OF MOBILE, P.C.
Plan administrator’s address 3 MOBILE INFIRMARY CIRCLE SUITE 305, MOBILE, AL, 366073515
Administrator’s telephone number 2514335557

Signature of

Role Plan administrator
Date 2011-07-13
Name of individual signing DR. LEE THOMPSON
CANCER SURGERY OF MOBILE, P.C. PROFIT SHARING PLAN 2009 631120875 2010-10-14 CANCER SURGERY OF MOBILE, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-07-01
Business code 621111
Sponsor’s telephone number 2514335557
Plan sponsor’s address 3 MOBILE INFIRMARY CIRCLE SUITE 305, MOBILE, AL, 366073515

Plan administrator’s name and address

Administrator’s EIN 631120875
Plan administrator’s name CANCER SURGERY OF MOBILE, P.C.
Plan administrator’s address 3 MOBILE INFIRMARY CIRCLE SUITE 305, MOBILE, AL, 366073515
Administrator’s telephone number 2514335557

Signature of

Role Plan administrator
Date 2010-10-14
Name of individual signing DR. LEE THOMPSON
CANCER SURGERY OF MOBILE, P.C. PROFIT SHARING PLAN 2009 631120875 2010-10-14 CANCER SURGERY OF MOBILE, P.C. 11
Three-digit plan number (PN) 001
Effective date of plan 1994-07-01
Business code 621111
Sponsor’s telephone number 2514335557
Plan sponsor’s address 3 MOBILE INFIRMARY CIRCLE SUITE 305, MOBILE, AL, 366073515

Plan administrator’s name and address

Administrator’s EIN 631120875
Plan administrator’s name CANCER SURGERY OF MOBILE, P.C.
Plan administrator’s address 3 MOBILE INFIRMARY CIRCLE SUITE 305, MOBILE, AL, 366073515
Administrator’s telephone number 2514335557

Signature of

Role Plan administrator
Date 2010-10-14
Name of individual signing DR. LEE THOMPSON

Agent

Name Role
WALKER, GAYLORD T Agent

Incorporator

Name Role
WALKER, GAYLORD T MD Incorporator

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State