| Name: | Southern Pain Specialists, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 03 Oct 1997 (27 years ago) (Companies founded in October 1997) |
| Entity Number: | 000-190-618 |
| Register Number: | 000190618 |
| ZIP code: | 35242 (Companies in Shelby, 35242) |
| County: | Shelby |
| Place of Formation: | Shelby County |
| Registered Office Street Address: | 7500 HUGH DANIEL DRIVE, STE 360BIRMINGHAM, AL 35242 |
| Authorized Capital: | $1,000 |
Activities
PRACTICE MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174697106 | 2006-11-20 | 2013-06-12 | 7191 CAHABA VALLEY RD, SUITE 204, BIRMINGHAM, AL, 352426402, US | 7191 CAHABA VALLEY RD, SUITE 204, BIRMINGHAM, AL, 352426402, US | |||||||||||||||||||||||||||
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| Phone | +1 205-995-9967 |
| Fax | 2059950635 |
Authorized person
| Name | DR. KENNETH G VARLEY |
| Role | PRESIDENT |
| Phone | 2059959967 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | 491 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| License Number | 19582 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| VARLEY, KENNETH G | Agent |
| Name | Role |
|---|---|
| VARLEY, KENNETH G | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
