| Name: | Huntsville Neurology Center, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 03 Jan 2005 (20 years ago) |
| Date of dissolution: | 29 Apr 2013 |
| Entity Number: | 000-238-992 |
| Register Number: | 000238992 |
| County: | Madison |
| Place of Formation: | Madison County |
| Principal Address: | HUNTSVILLE, AL |
| Registered Office Street Address: | 2350 WHITESBURG DRHUNTSVILLE, AL 35801 |
| Registered Office Street Address ZIP Code: | 35801 |
| Authorized Capital: | $1,000 |
Activities
PRACTICE NEUROLOGICAL MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417090366 | 2007-02-14 | 2020-08-22 | 2350 WHITESBURG DR S, HUNTSVILLE, AL, 358013818, US | 2350 WHITESBURG DR S, HUNTSVILLE, AL, 358013818, US | |||||||||||||||||||||||
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| Phone | +1 256-258-0052 |
Authorized person
| Name | MR. RAVI YANAMADULA |
| Role | OFFICE MANAGER |
| Phone | 2562580052 |
Taxonomy
| Taxonomy Code | 2084N0400X - Neurology Physician |
| License Number | 00022841 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHEILD |
| Number | 51002898 |
| State | AL |
| Name | Role |
|---|---|
| NUTHI, USHA | Agent |
| Name | Role |
|---|---|
| NUTHI, USHA | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
