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Temple Medical Clinic, P.C.

Details

Name: Temple Medical Clinic, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 16 Jul 1997 (27 years ago) (Companies founded in July 1997)
Entity Number: 000-189-102
Register Number: 000189102
ZIP code: 36853 (Companies in Tallapoosa, 36853)
County: Tallapoosa
Place of Formation: Tallapoosa County
Principal Address: DADEVILLE, AL
Registered Office Street Address: 2522 HERRON STREETDADEVILLE, AL 36853
Authorized Capital: $10,000
Paid Share Capital: $2,000

Activities PRACTICE MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1477629434 2006-11-28 2011-11-07 859 AIRPORT DRIVE, ALEXANDER CITY, AL, 350103443, US 859 AIRPORT DRIVE, ALEXANDER CITY, AL, 350103443, US

Contacts
Phone +1 256-234-4295
Fax 2563291024

Authorized person
Name DR. JAMES PITTS TEMPLE
Role PRESIDENT
Phone 2562344295

Taxonomy
Taxonomy Code 261Q00000X - Clinic/Center
Is Primary Yes

Other Provider Identifiers
Issuer MEDICARE TRAVELERS
Number CG2343
State AL
Issuer MEDICAID
Number 529703750
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TEMPLE MEDICAL CLINIC, P.C. RETIREMENT PLAN 2023 721387623 2024-08-22 TEMPLE MEDICAL CLINIC, P.C. 44
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 2562344295
Plan sponsor’s address P.O. BOX 268, ALEXANDER CITY, AL, 350110268

Signature of
Role Plan administrator
Date 2024-08-22
Name of individual signing LINDA T BREWER
TEMPLE MEDICAL CLINIC, P.C. RETIREMENT PLAN 2022 721387623 2023-08-02 TEMPLE MEDICAL CLINIC, P.C. 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 2562344295
Plan sponsor’s address P.O. BOX 268, ALEXANDER CITY, AL, 350110268

Signature of
Role Plan administrator
Date 2023-08-02
Name of individual signing LINDA T BREWER
TEMPLE MEDICAL CLINIC, P.C. RETIREMENT PLAN 2021 721387623 2022-09-14 TEMPLE MEDICAL CLINIC, P.C. 44
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 2562344295
Plan sponsor’s address P.O. BOX 268, ALEXANDER CITY, AL, 35011

Signature of
Role Plan administrator
Date 2022-09-14
Name of individual signing LINDA T BREWER
TEMPLE MEDICAL CLINIC, P.C. RETIREMENT PLAN 2021 721387623 2022-09-26 TEMPLE MEDICAL CLINIC, P.C. 44
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 2562344295
Plan sponsor’s address P.O. BOX 268, ALEXANDER CITY, AL, 35011

Signature of
Role Plan administrator
Date 2022-09-26
Name of individual signing LINDA T BREWER
TEMPLE MEDICAL CLINIC, P.C. RETIREMENT PLAN 2020 721387623 2021-06-08 TEMPLE MEDICAL CLINIC, P.C. 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 2562344295
Plan sponsor’s address P.O. BOX 268, ALEXANDER CITY, AL, 35011

Signature of
Role Plan administrator
Date 2021-06-08
Name of individual signing LINDA T BREWER
TEMPLE MEDICAL CLINIC, P.C. RETIREMENT PLAN 2019 721387623 2020-07-17 TEMPLE MEDICAL CLINIC, P.C. 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 2562344295
Plan sponsor’s address P.O. BOX 268, ALEXANDER CITY, AL, 35011

Signature of
Role Plan administrator
Date 2020-07-17
Name of individual signing LINDA T BREWER
TEMPLE MEDICAL CLINIC, P.C. RETIREMENT PLAN 2018 721387623 2019-08-09 TEMPLE MEDICAL CLINIC, P.C. 39
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 2562344295
Plan sponsor’s address P.O. BOX 268, ALEXANDER CITY, AL, 35011

Signature of
Role Plan administrator
Date 2019-08-09
Name of individual signing LINDA T BREWER
TEMPLE MEDICAL CLINIC, P.C. RETIREMENT PLAN 2017 721387623 2018-08-24 TEMPLE MEDICAL CLINIC, P.C. 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 2562344295
Plan sponsor’s address P.O. BOX 268, ALEXANDER CITY, AL, 35011

Signature of
Role Plan administrator
Date 2018-08-24
Name of individual signing LINDA T BREWER
TEMPLE MEDICAL CLINIC, P.C. RETIREMENT PLAN 2016 721387623 2017-10-09 TEMPLE MEDICAL CLINIC, P.C. 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 2562344295
Plan sponsor’s address P.O. BOX 268, ALEXANDER CITY, AL, 35010

Signature of
Role Plan administrator
Date 2017-10-09
Name of individual signing LINDA T BREWER
TEMPLE MEDICAL CLINIC, P.C. RETIREMENT PLAN 2015 721387623 2016-07-12 TEMPLE MEDICAL CLINIC, P.C. 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 2562344295
Plan sponsor’s address 859 AIRPORT DRIVE, ALEXANDER CITY, AL, 35010

Signature of
Role Plan administrator
Date 2016-07-12
Name of individual signing LINDA T BREWER

Agent

Name Role
TEMPLE, JAMES P Agent

Incorporator

Name Role
TEMPLE, JAMES P Incorporator
CORBIN, TIMOTHY J Incorporator

Events

Event Date Event Type Old Value New Value
2002-08-12 Capital Change $2,000 Authorized $2,000 Paid In $10,000 Authorized $2,000 Paid In

Related by officers

TEMPLE, JAMES P

Alex City Tire & Service Center, Inc. Physicians Hospital of Dadeville, Incorporated Alexander City Texaco Service Center, Inc. Medical Village Properties, L.L.C. The Professional Commons, L.L.C. Village Studios IVX, LLC LaTem Distributors, Inc. Marble City Nursing Home, Inc. New Superior Cleaners, Inc. Property Investors Corporation

CORBIN, TIMOTHY J

Medical Village Properties, L.L.C.

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DADEVILLE, AL

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Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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