| Name: | Summit Internal Medicine, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 06 Jun 2003 (21 years ago) |
| Entity Number: | 000-229-493 |
| Register Number: | 000229493 |
| Place of Formation: | Shelby County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 1019 WILLIAMS TRACEBIRMINGHAM, AL 35242-7825 |
| Authorized Capital: | $10 |
Activities
INTERNAL MEDICINE PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952454746 | 2007-01-18 | 2016-04-18 | 3570 GRANDVIEW PARKWAY, SUITE 100-A, BIRMINGHAM, AL, 352432033, US | 3570 GRANDVIEW PARKWAY SUITE 100-A, BIRMINGHAM, AL, 352432033, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 205-595-9222 |
| Fax | 2055959444 |
Authorized person
| Name | DR. DAVID FRANK WYNNE |
| Role | DOCTOR |
| Phone | 2055959222 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | 00021252 |
| State | AL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SUMMIT INTERNAL MEDICINE P.C. 401(K) PLAN | 2023 | 421594377 | 2024-07-30 | SUMMIT INTERNAL MEDICINE P.C. | 7 | |||||||||||||||||||||
|
||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2024-07-30 |
| Name of individual signing | DAVID F. WYNNE |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-08-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2055959222 |
| Plan sponsor’s address | 3570 GRANDVIEW PARKWAY, SUITE 100A, BIRMINGHAM, AL, 35243 |
Signature of
| Role | Plan administrator |
| Date | 2023-09-08 |
| Name of individual signing | DAVID F. WYNNE |
| Name | Role |
|---|---|
| WYNNE, DAVID F | Agent |
| Name | Role | Address |
|---|---|---|
| IRBY, RUSSELL L III | Incorporator | 1819 5TH AVENUE NORTH, SUITE 1000BIRMINGHAM, AL 35203 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
