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Metro West Medical Group, P.C.

Details

Name: Metro West Medical Group, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 24 Feb 2000 (25 years ago)
Entity Number: 000-208-262
Register Number: 000208262
County: Jefferson
Place of Formation: Jefferson County
Principal Address: FAIRFIELD, AL
Registered Office Street Address: 701 RICHARD M SCHRUSHY PARKWAYFAIRFIELD, AL 35064
Registered Office Street Address ZIP Code: 35064
Authorized Capital: $2,000

Activities MEDICAL PRACTICE/SPECIALIZING IN INTERNAL MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1851439582 2007-02-02 2007-07-19 801 PRINCETON AVE SW, POB I SUITE 406, BIRMINGHAM, AL, 352111310, US 801 PRINCETON AVE SW, POB I SUITE 406, BIRMINGHAM, AL, 352111310, US

Contacts
Phone +1 205-788-6688
Fax 2057880305

Authorized person
Name DR. WILLIE WILLIAMS JR.
Role PRESIDENT
Phone 2053979214

Taxonomy
Taxonomy Code 207R00000X - Internal Medicine Physician
Is Primary Yes
Taxonomy Code 207RR0500X - Rheumatology Physician
Is Primary No

Other Provider Identifiers
Issuer JGL UHC
Number 0410343
State AL
Issuer UHC
Number 0101621
State AL
Issuer JDM UHC
Number 0410383
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
METRO WEST MEDICAL GROUP RETIREMENT SAVINGS PLAN 2018 631244265 2019-08-15 METRO WEST MEDICAL GROUP, P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-05-01
Business code 621111
Sponsor’s telephone number 2053979210
Plan sponsor’s address 801 PRINCETON AVENUE POB 1, STE 406, BIRMINGHAM, AL, 35211

Signature of
Role Plan administrator
Date 2019-08-15
Name of individual signing WILLIE WILLIAMS JR MD
METRO WEST MEDICAL GROUP RETIREMENT SAVINGS PLAN 2018 631244265 2019-06-25 METRO WEST MEDICAL GROUP, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-05-01
Business code 621111
Sponsor’s telephone number 2053979210
Plan sponsor’s address 801 PRINCETON AVENUE POB 1, STE 406, BIRMINGHAM, AL, 35211

Signature of
Role Plan administrator
Date 2019-06-25
Name of individual signing WILLIE WILLIAMS JR MD
METRO WEST MEDICAL GROUP RETIREMENT SAVINGS PLAN 2017 631244265 2018-08-27 METRO WEST MEDICAL GROUP, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-05-01
Business code 621111
Sponsor’s telephone number 2053979210
Plan sponsor’s address 801 PRINCETON AVENUE POB 1, STE 406, BIRMINGHAM, AL, 35211

Signature of
Role Plan administrator
Date 2018-08-27
Name of individual signing WILLIE WILLIAMS JR MD
METRO WEST MEDICAL GROUP RETIREMENT SAVINGS PLAN 2016 631244265 2017-10-12 METRO WEST MEDICAL GROUP, P.C. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-05-01
Business code 621111
Sponsor’s telephone number 2053979210
Plan sponsor’s address 801 PRINCETON AVENUE POB 1, STE 406, BIRMINGHAM, AL, 35211

Signature of
Role Plan administrator
Date 2017-10-12
Name of individual signing WILLIE WILLIAMS JR MD
METRO WEST MEDICAL GROUP RETIREMENT SAVINGS PLAN 2015 631244265 2017-10-12 METRO WEST MEDICAL GROUP, P.C. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-05-01
Business code 621111
Sponsor’s telephone number 2053979210
Plan sponsor’s address 801 PRINCETON AVENUE POB 1, STE 406, BIRMINGHAM, AL, 35211

Signature of
Role Plan administrator
Date 2017-10-12
Name of individual signing WILLIE WILLIAMS JR MD
METRO WEST MEDICAL GROUP RETIREMENT SAVINGS PLAN 2015 631244265 2016-08-30 METRO WEST MEDICAL GROUP, P.C. 14
Three-digit plan number (PN) 001
Effective date of plan 2002-05-01
Business code 621111
Sponsor’s telephone number 2053979210
Plan sponsor’s address 801 PRINCETON AVENUE POB 1, STE 406, BIRMINGHAM, AL, 35211

Signature of
Role Plan administrator
Date 2016-08-30
Name of individual signing WILLIE WILLIAMS JR MD
METRO WEST MEDICAL GROUP RETIREMENT SAVINGS PLAN 2014 631244265 2015-09-11 METRO WEST MEDICAL GROUP, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-05-01
Business code 621111
Sponsor’s telephone number 2057886688
Plan sponsor’s address 801 PRINCETON AVENUE POB 1, STE 406, BIRMINGHAM, AL, 35211

Signature of
Role Plan administrator
Date 2015-09-11
Name of individual signing WILLIE WILLIAMS JR MD
METRO WEST MEDICAL GROUP RETIREMENT SAVINGS PLAN 2013 631244265 2014-09-04 METRO WEST MEDICAL GROUP, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-05-01
Business code 621111
Sponsor’s telephone number 2057886688
Plan sponsor’s address 801 PRINCETON AVENUE POB 1, STE 406, BIRMINGHAM, AL, 35211

Signature of
Role Plan administrator
Date 2014-09-04
Name of individual signing WILLIE WILLIAMS JR MD
METRO WEST MEDICAL GROUP RETIREMENT SAVINGS PLAN 2012 631244265 2013-09-13 METRO WEST MEDICAL GROUP, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-05-01
Business code 621111
Sponsor’s telephone number 2057886688
Plan sponsor’s address 801 PRINCETON AVENUE POB 1, STE 406, BIRMINGHAM, AL, 35211

Signature of
Role Plan administrator
Date 2013-09-13
Name of individual signing WILLIE WILLIAMS JR MD
METRO WEST MEDICAL GROUP RETIREMENT SAVINGS PLAN 2011 631244265 2012-10-11 METRO WEST MEDICAL GROUP, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-05-01
Business code 621111
Sponsor’s telephone number 2057886688
Plan sponsor’s address 801 PRINCETON AVENUE POB 1, STE 406, BIRMINGHAM, AL, 35211

Plan administrator’s name and address
Administrator’s EIN 631244265
Plan administrator’s name METRO WEST MEDICAL GROUP, P.C.
Plan administrator’s address 801 PRINCETON AVENUE POB 1, STE 406, BIRMINGHAM, AL, 35211
Administrator’s telephone number 2057886688

Signature of
Role Plan administrator
Date 2012-10-11
Name of individual signing WILLIE WILLIAMS JR MD

Agent

Name Role
WILLIAMS, WILLIE JR Agent

Incorporator

Name Role
FARMER, WILLIAM ROY III Incorporator

Related by officers

WILLIAMS, WILLIE JR

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Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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