| Name: | South Alabama Radiation-Oncology, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 17 Aug 1994 (30 years ago) |
| Date of dissolution: | 06 Aug 2019 |
| Entity Number: | 000-166-065 |
| Register Number: | 000166065 |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Principal Address: | MOBILE, AL |
| Registered Office Street Address: | 51-D TACON STMOBILE, AL 36607 |
| Registered Office Street Address ZIP Code: | 36607 |
| Authorized Capital: | $5,000 |
| Paid Share Capital: | ---- |
Activities
PRACTICE OF ONCOLOGY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1841384138 | 2006-10-03 | 2010-12-02 | PO BOX 1380, FOLEY, AL, 36536, US | 1703 N BUNNER ST, FOLEY, AL, 365352229, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 251-626-1755 |
| Fax | 2516261755 |
| Fax | 2519801683 |
Authorized person
| Name | WILLIAM CARROLL HIXSON |
| Role | OWNER PRESIDENT |
| Phone | 2519431680 |
Taxonomy
| Taxonomy Code | 2085R0001X - Radiation Oncology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | CLIA |
| Number | 01D1068466 |
| State | AL |
| Issuer | RR MEDICARE |
| Number | CC3256 |
| State | AL |
| Issuer | BCBS |
| Number | 51524757 |
| State | AL |
| Issuer | MEDICAID |
| Number | 529601710 |
| State | AL |
| Name | Role |
|---|---|
| WEAVER, JOSEPH WILLIAM | Agent |
| Name | Role |
|---|---|
| BUJNOSKI, JOANNE L | Incorporator |
| WEAVER, JOSEPH WILLIAM | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
