| Name: | North Alabama Obstetrics & Gynecology, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 16 May 1996 (29 years ago) (Companies founded in May 1996) |
| Entity Number: | 000-179-829 |
| Register Number: | 000179829 |
| ZIP code: | 35802 (Companies in Madison, 35802) |
| County: | Madison |
| Place of Formation: | Limestone County |
| Principal Address: | HUNTSVILLE, AL |
| Registered Office Street Address: | 333 WHITESPORT DRIVE STE 203HUNTSVILLE, AL 35802 |
| Authorized Capital: | $5,000 |
| Paid Share Capital: | -- |
Activities
OBSTETRICS/GYNECOLOGY MEDICAL PROFESSION
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194811497 | 2006-10-05 | 2020-08-22 | 3809 SULLIVAN ST, SUITE 6-A, MADISON, AL, 357582372, US | 3809 SULLIVAN ST, SUITE 6-A, MADISON, AL, 357582372, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 256-461-4104 |
| Fax | 2564614840 |
Authorized person
| Name | DR. RAYMOND A LOPEZ |
| Role | OWNER |
| Phone | 2564614104 |
Taxonomy
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | 18239 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS&BLUE SHIELD |
| Number | 51097396 |
| State | AL |
| Name | Role |
|---|---|
| LOPEZ, RAYMOND A | Agent |
| Name | Role |
|---|---|
| LOPEZ, RAYMOND A | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
