| Name: | Tennessee Valley Family Practice Associates, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 13 Nov 1995 (29 years ago) |
| Entity Number: | 000-175-586 |
| Register Number: | 000175586 |
| County: | Jackson |
| Place of Formation: | Jackson County |
| Principal Address: | BRIDGEPORT, AL |
| Registered Office Street Address: | 47053 US HWY 72 STE CBRIDGEPORT, AL 35740 |
| Registered Office Street Address ZIP Code: | 35740 |
| Authorized Capital: | $100 |
| Paid Share Capital: | $100 |
Activities
RENDERING OF PROFESSIONAL MEDICAL SERVICES/ETC
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386075976 | 2013-12-06 | 2014-01-30 | 47053 AL HIGHWAY 277, SUITE C, BRIDGEPORT, AL, 357407205, US | 47053 AL HIGHWAY 277, SUITE C, BRIDGEPORT, AL, 357407205, US | |||||||||||||||||
|
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| Phone | +1 256-437-0555 |
Authorized person
| Name | JERRY CHRIS BLEVINS |
| Role | OWNER |
| Phone | 2564370555 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 7850 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| BLEVINS, JERRY CHRISTOPHER | Agent |
| Name | Role |
|---|---|
| BLEVINS, JERRY CHRISTOPHER | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
