| Name: | Family Medicine of Sardis, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 20 Jan 2004 (21 years ago) |
| Entity Number: | 000-233-124 |
| Register Number: | 000233124 |
| County: | Etowah |
| Place of Formation: | Etowah County |
| Principal Address: | BOAZ, AL |
| Registered Office Street Address: | 1180 SARDIS DRBOAZ, AL 35956 |
| Registered Office Street Address ZIP Code: | 35956 |
| Authorized Capital: | $1,000 |
Activities
MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245398304 | 2006-12-04 | 2007-12-11 | PO BOX 1049, BOAZ, AL, 359572201, US | 1180 SARDIS DR, SARDIS CITY, AL, 359562139, US | |||||||||||||||||||
|
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| Phone | +1 256-593-9999 |
| Fax | 2565939141 |
Authorized person
| Name | DR. EVAN MICHAEL JOHNSON |
| Role | PRESIDENT, OWNER |
| Phone | 2565939999 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | DO779 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| JOHNSON, EVAN M | Agent |
| Name | Role |
|---|---|
| JOHNSON, EVAN M | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
