| Name: | Shelby Plastic Surgery, Skin Cancer, & Laser Surgery Center, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 12 Sep 1995 (29 years ago) (Companies founded in September 1995) |
| Entity Number: | 000-174-393 |
| Register Number: | 000174393 |
| ZIP code: | 35007 (Companies in Shelby, 35007) |
| County: | Shelby |
| Place of Formation: | Shelby County |
| Principal Address: | ALABASTER, AL |
| Registered Office Street Address: | 1216 FIRST ST NORTH US HWY 31ALABASTER, AL 35007 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | ---- |
Activities
PRACTICE OF MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104847706 | 2006-07-21 | 2020-08-22 | 1216 1ST ST N, HWY 31, ALABASTER, AL, 350078702, US | 1216 1ST ST N, HWY 31, ALABASTER, AL, 350078702, US | |||||||||||||||||||
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| Phone | +1 205-664-4630 |
| Fax | 2056644658 |
Authorized person
| Name | DR. CLEMENT P. COTTER JR. |
| Role | CEO |
| Phone | 2056644630 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | 00010998 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| COTTER, CLEMENT P JR | Agent | 5170 PARK TRACE DRIVEHOOVER, AL 35244 |
| Name | Role | Address |
|---|---|---|
| COTTER, CLEMENT P JR | Incorporator | 5170 PARK TRACE DRIVEHOOVER, AL 35244 |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
