| Name: | Dr. Dale Mitchum, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 14 Jan 2005 (20 years ago) |
| Entity Number: | 000-239-186 |
| Register Number: | 000239186 |
| County: | Geneva |
| Place of Formation: | Geneva County |
| Principal Address: | GENEVA, AL |
| Registered Office Street Address: | 2 W LAKE LAKE PROFESSIONAL PKGENEVA, AL 36340 |
| Registered Office Street Address ZIP Code: | 36340 |
| Authorized Capital: | $10,000 |
Activities
PRACTICE MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407299894 | 2013-04-16 | 2013-04-16 | PO BOX 900, GENEVA, AL, 363400900, US | 100 W LAKE PROFESSIONAL PARK STE 2, GENEVA, GENEVA, AL, 363401200, US | |||||||||||||||||||||||
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| Phone | +1 334-684-3007 |
| Fax | 3346843059 |
Authorized person
| Name | DR. DALE G MITCHUM |
| Role | OWNER |
| Phone | 3346843007 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 12381 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 208600000X - Surgery Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| MITCHUM, DALE | Agent |
| Name | Role |
|---|---|
| MITCHUM, DALE | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
