Name: | North Alabama ENT Associates, P.C. |
Jurisdiction: | Alabama |
Legal type: | Domestic Professional Corporation |
Status: | Exists |
Date of registration: | 05 Aug 1997 (27 years ago) |
Entity Number: | 000-189-490 |
Register Number: | 000189490 |
County: | Madison |
Place of Formation: | Madison County |
Principal Address: | HUNTSVILLE, AL |
Registered Office Street Address: | 927 FRANKLIN ST STE 100HUNTSVILLE, AL 35801 |
Registered Office Street Address ZIP Code: | 35801 |
Authorized Capital: | 100 |
Activities
MEDICAL PRACTICE
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1215057492 | 2007-03-30 | 2013-12-06 | PO BOX 18066, HUNTSVILLE, AL, 358048066, US | 8337 HIGHWAY 72 W, SUITE 301, MADISON, AL, 357589547, US | |||||||||||||||||||||||||||||||
|
Phone | +1 256-536-9300 |
Fax | 2565359032 |
Phone | +1 256-772-1884 |
Fax | 2567721886 |
Authorized person
Name | HERMAN MCKINLEY TEACHEY |
Role | PRESIDENT |
Phone | 2565369300 |
Taxonomy
Taxonomy Code | 207Y00000X - Otolaryngology Physician |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID |
Number | 529704220 |
State | AL |
Issuer | MEDICAID |
Number | 529703900 |
State | AL |
Name | Role |
---|---|
MCCARY, SCOTT W | Agent |
Name | Role |
---|---|
MARTIN, RICHARD G | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State