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Scottsboro ENT, P.C.

Details

Name: Scottsboro ENT, P.C.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 03 Apr 2002 (23 years ago) (Companies founded in April 2002)
Entity Number: 000-222-099
Register Number: 000222099
ZIP code: 35768 (Companies in Jackson, 35768)
County: Jackson
Place of Formation: Jackson County
Principal Address: SCOTTSBORO, AL
Registered Office Street Address: 380 WOODS COVE RD STE ASCOTTSBORO, AL 35768
Authorized Capital: $3,000
Paid Share Capital: $3,000

Activities PRACTICE OTORHINOLARYNGOLOGY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1942368014 2006-12-04 2024-08-27 406 TAYLOR ST STE B, SCOTTSBORO, AL, 357682406, US 406 TAYLOR ST STE B, SCOTTSBORO, AL, 357682406, US

Contacts
Phone +1 256-574-6100
Fax 2565743004

Authorized person
Name DR. DARBY D MARSHALL
Role PRESIDENT
Phone 2565746100

Taxonomy
Taxonomy Code 207Y00000X - Otolaryngology Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SCOTTSBORO ENT, P.C. 401(K) PROFIT SHARING PLAN 2023 731636016 2024-10-07 SCOTTSBORO ENT, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 2565746100
Plan sponsor’s address 406B TAYLOR STREET, SCOTTSBORO, AL, 357682406

Signature of
Role Plan administrator
Date 2024-10-07
Name of individual signing VICKY ADKINS
Valid signature Filed with authorized/valid electronic signature
SCOTTSBORO ENT, P.C. 401(K) PROFIT SHARING PLAN 2022 731636016 2023-03-17 SCOTTSBORO ENT, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 2565746100
Plan sponsor’s address 406B TAYLOR STREET, SCOTTSBORO, AL, 35768

Signature of
Role Plan administrator
Date 2023-03-17
Name of individual signing VICKY ADKINS
SCOTTSBORO ENT, P.C. 401(K) PROFIT SHARING PLAN 2021 731636016 2022-06-20 SCOTTSBORO ENT, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 2565746100
Plan sponsor’s address 406B TAYLOR STREET, SCOTTSBORO, AL, 35768

Signature of
Role Plan administrator
Date 2022-06-20
Name of individual signing VICKY ADKINS
SCOTTSBORO ENT, P.C. 401(K) PROFIT SHARING PLAN 2020 731636016 2021-03-09 SCOTTSBORO ENT, P.C. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 2565746100
Plan sponsor’s address 406B TAYLOR STREET, SCOTTSBORO, AL, 35768

Signature of
Role Plan administrator
Date 2021-03-09
Name of individual signing VICKY ADKINS
SCOTTSBORO ENT, P.C. 401(K) PROFIT SHARING PLAN 2019 731636016 2020-09-28 SCOTTSBORO ENT, P.C. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 2565746100
Plan sponsor’s address 406B TAYLOR STREET, SCOTTSBORO, AL, 35768

Signature of
Role Plan administrator
Date 2020-09-28
Name of individual signing VICKY ADKINS
SCOTTSBORO ENT, P.C. CASH BALANCE PENSION PLAN 2018 731636016 2019-09-17 SCOTTSBORO ENT, P.C. 15
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2565746100
Plan sponsor’s address 406B TAYLOR STREET, SCOTTSBORO, AL, 35768

Plan administrator’s name and address
Administrator’s EIN 731636016
Plan administrator’s name SCOTTSBORO ENT, P.C.
Plan administrator’s address 406B TAYLOR STREET, SCOTTSBORO, AL, 35768
Administrator’s telephone number 2565746100

Signature of
Role Plan administrator
Date 2019-09-17
Name of individual signing VICKY ADKINS
SCOTTSBORO ENT, P.C. 401(K) PROFIT SHARING PLAN 2018 731636016 2019-06-01 SCOTTSBORO ENT, P.C. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 2565746100
Plan sponsor’s address 406B TAYLOR STREET, SCOTTSBORO, AL, 35768

Signature of
Role Plan administrator
Date 2019-06-01
Name of individual signing VICKY ADKINS
SCOTTSBORO ENT, P.C. CASH BALANCE PENSION PLAN 2018 731636016 2019-09-17 SCOTTSBORO ENT, P.C. 15
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2565746100
Plan sponsor’s address 406B TAYLOR STREET, SCOTTSBORO, AL, 35768

Signature of
Role Plan administrator
Date 2019-09-17
Name of individual signing VICKY ADKINS
SCOTTSBORO ENT, P.C. CASH BALANCE PENSION PLAN 2017 731636016 2018-10-15 SCOTTSBORO ENT, P.C. 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2565746100
Plan sponsor’s address 406B TAYLOR STREET, SCOTTSBORO, AL, 35768

Plan administrator’s name and address
Administrator’s EIN 731636016
Plan administrator’s name SCOTTSBORO ENT, P.C.
Plan administrator’s address 406B TAYLOR STREET, SCOTTSBORO, AL, 35768
Administrator’s telephone number 2565746100

Signature of
Role Plan administrator
Date 2018-10-15
Name of individual signing VICKY ADKINS
SCOTTSBORO ENT, P.C. 401(K) PROFIT SHARING PLAN 2017 731636016 2018-04-03 SCOTTSBORO ENT, P.C. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 2565746100
Plan sponsor’s address 406B TAYLOR STREET, SCOTTSBORO, AL, 35768

Signature of
Role Plan administrator
Date 2018-04-03
Name of individual signing VICKY ADKINS

Agent

Name Role
ORTIZ, DANIEL L Agent

Incorporator

Name Role
ORTIZ, DANIEL L Incorporator

Related by officers

No related officers

Related by address

SCOTTSBORO, AL

Abercrombie's Tire Center, Inc. I. E. Airheart & Son, Inc. Alabama Leasing Corporation Allen Mobile Home Parks, Inc. Benham Corporation Copeland Tire Company, Inc. Derrick's Department Store, Inc. Farm Bureau Service Center of Jackson, Inc. Farm Service Chemical Co., Inc. Fred's Dollar Store of Scottsboro, Inc.

380 WOODS COVE RD STE ASCOTTSBORO, AL 35768

Premier Orthopaedics and Sports Medicine, LLC

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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