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 | |||||||||||||||||||||||||||||||||||||||
|
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