| Name: | Valley Obstetrics & Gynecology, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 12 Jul 2000 (24 years ago) |
| Date of dissolution: | 09 Jul 2020 |
| Entity Number: | 000-211-304 |
| Register Number: | 000211304 |
| County: | Limestone |
| Place of Formation: | Limestone County |
| Principal Address: | ATHENS, AL |
| Registered Office Street Address: | 1005 WEST MARKET ST STE 17ATHENS, AL 35611 |
| Registered Office Street Address ZIP Code: | 35611 |
| Authorized Capital: | $5,000 |
| Paid Share Capital: | $5,000 |
Activities
OPERATE A MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912185513 | 2008-02-06 | 2008-03-06 | 725 W MARKET ST, SUITE B, ATHENS, AL, 356112456, US | 725 W MARKET ST, SUITE B, ATHENS, AL, 356112456, US | |||||||||||||||||||||||||||||||
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| Phone | +1 256-233-5000 |
| Fax | 2562335361 |
Authorized person
| Name | THOMAS CLIFTON PITMAN |
| Role | PHYSICIAN PRESIDENT VALLEY OBGYN PC |
| Phone | 2562335000 |
Taxonomy
| Taxonomy Code | 207VG0400X - Gynecology Physician |
| License Number | 00018174 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529905630 |
| State | AL |
| Issuer | MEDICAID |
| Number | 009937470 |
| State | AL |
| Name | Role |
|---|---|
| PITMAN, THOMAS C | Agent |
| Name | Role |
|---|---|
| PITMAN, THOMAS C | Incorporator |
| CARLOTA, OLIVER E | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
