| Name: | University Family Practice, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 26 Aug 1997 (27 years ago) |
| Date of dissolution: | 12 Nov 2020 |
| Entity Number: | 000-190-312 |
| Register Number: | 000190312 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Principal Address: | TUSCALOOSA, AL |
| Registered Office Street Address: | 904 ANNA AVETUSCALOOSA, AL 35401 |
| Registered Office Street Address ZIP Code: | 35401 |
| Authorized Capital: | $5,000 |
Activities
PRACTICE OF MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225137763 | 2006-09-21 | 2020-08-22 | 904 ANNA AVE, TUSCALOOSA, AL, 354012014, US | 904 ANNA AVE, TUSCALOOSA, AL, 354012014, US | |||||||||||||||
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| Phone | +1 205-345-6960 |
| Fax | 2053451147 |
Authorized person
| Name | DOUGLAS S REYNOLDS |
| Role | PHYSICIAN |
| Phone | 2053456960 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| GRUBBS, BOB A | Agent |
| Name | Role |
|---|---|
| GRUBBS, BOB A | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
