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North Alabama Radiology, P.C.

Details

Name: North Alabama Radiology, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 18 Nov 1999 (25 years ago) (Companies founded in November 1999)
Entity Number: 000-206-355
Register Number: 000206355
ZIP code: 35601 (Companies in Morgan, 35601)
County: Morgan
Place of Formation: Morgan County
Principal Address: DECATUR, AL
Registered Office Street Address: 118 EAST MOULTONDECATUR, AL 35601
Authorized Capital: $1,000

Activities RADIOLOGICAL MEDICINE

National Provider Identifier

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

Contacts

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

Agent

Name Role Address
JOKICH, MICHAEL D Agent 209 VERANDA DRIVEMADISON, AL 35758

Incorporator

Name Role Address
JOKICH, MICHAEL D Incorporator 209 VERANDA DRIVEMADISON, AL 35758

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State