| Name: | David J Borcicky P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 19 May 2005 (20 years ago) (Companies founded in May 2005) |
| Entity Number: | 000-241-501 |
| Register Number: | 000241501 |
| ZIP code: | 36606 (Companies in Mobile, 36606) |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Principal Address: | MOBILE, AL |
| Registered Office Street Address: | 2152 AIRPORT BLVD APT 106MOBILE, AL 36606 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
Activities
PRACTICE MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518970664 | 2006-08-13 | 2008-11-13 | 2152 AIRPORT BLVD, SUITE 106, MOBILE, AL, 366061751, US | 2152 AIRPORT BLVD, SUITE 106, MOBILE, AL, 366061751, US | |||||||||||||||||||||||||||
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| Phone | +1 251-476-3338 |
| Fax | 2514734047 |
Authorized person
| Name | DR. DAVID JOHN BORCICKY |
| Role | OWNER |
| Phone | 2514763338 |
Taxonomy
| Taxonomy Code | 213E00000X - Podiatrist |
| License Number | 77 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | TRICARE HUMANA |
| Number | 129443828 |
| Issuer | RAILROAD MEDICARE |
| Number | 480033421 |
| Name | Role |
|---|---|
| BORCICKY, DAVID J | Agent |
| Name | Role |
|---|---|
| BORCICKY, DAVID J | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
