| Name: | FAMILY MEDICINE FOR YOUR FAMILY, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 14 Jun 2005 (19 years ago) |
| Entity Number: | 000-241-961 |
| Register Number: | 000241961 |
| Historical Names: |
Mark C. Cooper MD, P.C.
|
| County: | Jackson |
| Place of Formation: | Jackson County |
| Registered Office Street Address: | 505 BURLINGTON STSCOTTSBORO, AL 35768 |
| Registered Office Street Address ZIP Code: | 35768 |
| Authorized Capital: | 50 |
Activities
FAMILY MEDICAL CARE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811031883 | 2007-02-16 | 2020-07-30 | 505 BURLINGTON ST, SCOTTSBORO, AL, 357684216, US | 505 BURLINGTON ST, SCOTTSBORO, AL, 357684216, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 256-259-4100 |
| Fax | 2562594104 |
Authorized person
| Name | MARK C COOPER |
| Role | OWNER |
| Phone | 2562594100 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 22070 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529925920 |
| State | AL |
| Name | Role |
|---|---|
| COOPER, MARK C | Agent |
| Name | Role |
|---|---|
| COOPER, MARK C | Incorporator |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2017-10-03 | Name Change | Mark C. Cooper MD, P.C. | FAMILY MEDICINE FOR YOUR FAMILY, P.C. |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
