Menu
Search icon

Fairview Clinic, P.C.

Details

Name: Fairview Clinic, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 17 Oct 2002 (22 years ago)
Entity Number: 000-225-547
Register Number: 000225547
County: Houston
Place of Formation: Houston County
Registered Office Street Address: 1118 ROSS CLARK CIR STE 303DOTHAN, AL 36301
Registered Office Street Address ZIP Code: 36301
Authorized Capital: $1,200

Activities INTERNAL MEDICINE PRACTICE/SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1184693053 2006-03-14 2007-10-01 1118 ROSS CLARK CIR, SUITE 303, DOTHAN, AL, 363013001, US 1118 ROSS CLARK CIR, SUITE 303, DOTHAN, AL, 363013001, US

Contacts
Phone +1 334-794-3192
Fax 3347927513

Authorized person
Name MS. DEBBIE I YUREVICH
Role ADMINISTRATOR
Phone 3347943192

Taxonomy
Taxonomy Code 207R00000X - Internal Medicine Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FAIRVIEW CLINIC 401(K) PLAN 2023 061653223 2024-07-23 FAIRVIEW CLINIC 57
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 3347943192
Plan sponsor’s address 1118 ROSS CLARK DOCTORS BLDG., SUITE 303, DOTHAN, AL, 36301

Signature of
Role Plan administrator
Date 2024-07-23
Name of individual signing JAMES A ROBESON JR.
FAIRVIEW CLINIC 401(K) PLAN 2022 061653223 2023-06-02 FAIRVIEW CLINIC 45
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 3347943192
Plan sponsor’s address 1118 ROSS CLARK DOCTORS BLDG., SUITE 303, DOTHAN, AL, 36301

Signature of
Role Plan administrator
Date 2023-06-02
Name of individual signing JESSICA WINGAE
Role Employer/plan sponsor
Date 2023-06-02
Name of individual signing JESSICA WINGATE
FAIRVIEW CLINIC 401(K) PLAN 2021 061653223 2022-07-22 FAIRVIEW CLINIC 38
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 3347943192
Plan sponsor’s address 1118 ROSS CLARK DOCTORS BLDG., SUITE 303, DOTHAN, AL, 36301

Signature of
Role Plan administrator
Date 2022-07-22
Name of individual signing JESSICA WINGATE
Role Employer/plan sponsor
Date 2022-07-22
Name of individual signing JESSICA WINGATE
FAIRVIEW CLINIC 401(K) PLAN 2020 061653223 2021-05-12 FAIRVIEW CLINIC 39
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 3347943192
Plan sponsor’s address 1118 ROSS CLARK DOCTORS BLDG., SUITE 303, DOTHAN, AL, 36301

Signature of
Role Plan administrator
Date 2021-05-12
Name of individual signing JESSICA WINGATE
Role Employer/plan sponsor
Date 2021-05-12
Name of individual signing JESSICA WINGATE
FAIRVIEW CLINIC 401(K) PLAN 2019 061653223 2020-10-12 FAIRVIEW CLINIC 32
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 3347943192
Plan sponsor’s address 1118 ROSS CLARK DOCTORS BLDG., SUITE 303, DOTHAN, AL, 36301

Signature of
Role Plan administrator
Date 2020-10-12
Name of individual signing JESSICA WINGATE
FAIRVIEW CLINIC 401(K) PLAN 2018 061653223 2019-05-20 FAIRVIEW CLINIC 27
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 3347943192
Plan sponsor’s address 1118 ROSS CLARK DOCTORS BLDG., SUITE 303, DOTHAN, AL, 36301

Signature of
Role Plan administrator
Date 2019-05-20
Name of individual signing JESSICA WINGATE
FAIRVIEW CLINIC 401(K) PLAN 2017 061653223 2018-10-03 FAIRVIEW CLINIC 22
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 3347943192
Plan sponsor’s address 1118 ROSS CLARK DOCTORS BLDG., SUITE 303, DOTHAN, AL, 36301

Signature of
Role Plan administrator
Date 2018-10-03
Name of individual signing JESSICA WINGATE
FAIRVIEW CLINIC 401(K) PLAN 2016 061653223 2017-05-17 FAIRVIEW CLINIC 20
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 3347943192
Plan sponsor’s address 1118 ROSS CLARK DOCTORS BLDG., SUITE 303, DOTHAN, AL, 36301

Signature of
Role Plan administrator
Date 2017-05-17
Name of individual signing JESSICA WINGATE
FAIRVIEW CLINIC 401(K) PLAN 2015 061653223 2016-04-26 FAIRVIEW CLINIC 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 3347943192
Plan sponsor’s address 1118 ROSS CLARK DOCTORS BLDG., SUITE 303, DOTHAN, AL, 36301

Signature of
Role Plan administrator
Date 2016-04-26
Name of individual signing JESSICA WINGATE
FAIRVIEW CLINIC 401(K) PLAN 2014 061653223 2015-07-08 FAIRVIEW CLINIC 19
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 3347943192
Plan sponsor’s address 1118 ROSS CLARK DOCTORS BLDG., SUITE 303, DOTHAN, AL, 36301

Signature of
Role Plan administrator
Date 2015-07-08
Name of individual signing JESSICA WINGATE
Role Employer/plan sponsor
Date 2015-07-08
Name of individual signing JESSICA WINGATE

Agent

Name Role
MAZYCK, EARLE F Agent

Incorporator

Name Role
MAZYCK, EARLE F Incorporator

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2024 alabamacompanysearch.com, Part of Big Data Integrated