| Name: | Northshore Family Medicine, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 18 Oct 1996 (28 years ago) |
| Entity Number: | 000-183-063 |
| Register Number: | 000183063 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Principal Address: | TUSCALOOSA, AL |
| Registered Office Street Address: | 1820 RICE MINE RD STE 200TUSCALOOSA, AL 35406 |
| Registered Office Street Address ZIP Code: | 35406 |
| Authorized Capital: | $5,000 |
Activities
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104969898 | 2007-02-14 | 2010-06-23 | 303 BAY ST, SUITE 203, GADSDEN, AL, 359015265, US | 303 BAY ST, SUITE 203, GADSDEN, AL, 359015265, US | |||||||||||||||||||
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| Phone | +1 256-546-5232 |
| Fax | 2565465208 |
Authorized person
| Name | DR. THOMAS DWIGHT HARPER |
| Role | PHYSICIAN |
| Phone | 2565465232 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 17428 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| HARPER, THOMAS DWIGHT | Agent |
| Name | Role | Address |
|---|---|---|
| HAPRER, THOMAS DWIGHT | Incorporator | No data |
| KELLY, FREDERICK WAYNE | Incorporator | 1039 FORREST AVENUEGADSDEN, AL 35901 |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
