| Name: | Southern Anesthesia Specialists, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 02 Jan 1996 (29 years ago) |
| Date of dissolution: | 30 Dec 2013 |
| Entity Number: | 000-176-491 |
| Register Number: | 000176491 |
| County: | Tallapoosa |
| Place of Formation: | Tallapoosa County |
| Principal Address: | ALEXANDER CITY, AL |
| Registered Office Street Address: | 59 ALISON DRALEXANDER CITY, AL 35010 |
| Registered Office Street Address ZIP Code: | 35010 |
| Authorized Capital: | 100 NPV |
| Paid Share Capital: | $1,000 |
Activities
PRACTICE OF MEDICAL SPECIALTY OF ANESTHESIA
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700933140 | 2007-01-05 | 2007-09-07 | PO BOX 1074, ALEXANDER CITY, AL, 350111074, US | 3316 HIGHWAY 280, ALEXANDER CITY, AL, 350103369, US | |||||||||||||||||||||
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| Phone | +1 256-329-2938 |
| Fax | 2563292938 |
Authorized person
| Name | DR. GEORGE NELSON COOPER |
| Role | PRESIDENT |
| Phone | 2563292938 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS |
| Number | Q221 |
| State | AL |
| Name | Role |
|---|---|
| COOPER, G NELSON JR | Agent |
| Name | Role |
|---|---|
| COOPER, G NELSON JR | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
