| Name: | Hatfield Physician Services, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 17 Oct 1997 (27 years ago) |
| Entity Number: | 000-190-866 |
| Register Number: | 000190866 |
| ZIP code: | 35586 |
| County: | Lamar |
| Place of Formation: | Lamar County |
| Principal Address: | SULLIGENT, AL |
| Registered Office Street Address: | 211 BOYETT CIRCLESULLIGENT, AL 35586 |
| Authorized Capital: | $250 |
| Paid Share Capital: | $10 |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821150855 | 2006-12-15 | 2011-10-05 | PO BOX 1857, WINFIELD, AL, 355941419, US | 200 CARAWAY DR, SUITE 1, WINFIELD, AL, 355945048, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 205-487-3625 |
| Fax | 2054877559 |
Authorized person
| Name | DR. ERIC JASON HATFIELD |
| Role | PRESIDENT |
| Phone | 2054873625 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | DO-649 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 051550529 |
| State | AL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 05150448 |
| State | AL |
| Name | Role |
|---|---|
| HATFIELD, ERIC JASON | Agent |
| Name | Role |
|---|---|
| HATFIELD, ERIC JASON | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
