| Name: | Child Neurology and Seizure Specialists, PC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 04 Sep 1998 (26 years ago) |
| Entity Number: | 000-197-625 |
| Register Number: | 000197625 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Principal Address: | TUSCALOOSA, AL |
| Registered Office Street Address: | 1621 GREYSTONE DRTUSCALOOSA, AL 35406 |
| Registered Office Street Address ZIP Code: | 35406 |
| Authorized Capital: | $5,000 |
Activities
MEDICAL PROFESSION
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326100215 | 2006-12-15 | 2014-01-27 | 2702 HOSPITAL DR, SUITE 200, NORTHPORT, AL, 354763376, US | 2702 HOSPITAL DR, SUITE 200, NORTHPORT, AL, 354763376, US | |||||||||||||||||||||||||
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| Phone | +1 205-333-7075 |
| Fax | 2053333256 |
Authorized person
| Name | DR. ASHRAF AHSAN SYED |
| Role | PRESIDENT |
| Phone | 2053337075 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | 17109 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529902280 |
| State | AL |
| Name | Role |
|---|---|
| SYED, ASHRAF | Agent |
| Name | Role |
|---|---|
| SYED, ASHRAF | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
