| Name: | North Alabama Radiology, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 18 Nov 1999 (25 years ago) |
| Entity Number: | 000-206-355 |
| Register Number: | 000206355 |
| County: | Morgan |
| Place of Formation: | Morgan County |
| Principal Address: | DECATUR, AL |
| Registered Office Street Address: | 118 EAST MOULTONDECATUR, AL 35601 |
| Registered Office Street Address ZIP Code: | 35601 |
| Authorized Capital: | $1,000 |
Activities
RADIOLOGICAL MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982749461 | 2007-02-21 | 2008-02-18 | PO BOX 488, CULLMAN, AL, 350560488, US | 201 PINE ST NW, HARTSELLE, AL, 356402309, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 256-737-9416 |
| Fax | 2567365684 |
| Phone | +1 256-751-3000 |
| Fax | 2567513021 |
Authorized person
| Name | CANDIS C TOLBERT |
| Role | OFFICE MANAGER |
| Phone | 2567379416 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| License Number | 00022188 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1407072028 |
| Issuer | NPI |
| Number | 1891863395 |
| State | AL |
| Issuer | CHAMPUS |
| Number | CH8123 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| JOKICH, MICHAEL D | Agent | 209 VERANDA DRIVEMADISON, AL 35758 |
| Name | Role | Address |
|---|---|---|
| JOKICH, MICHAEL D | Incorporator | 209 VERANDA DRIVEMADISON, AL 35758 |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
