| Name: | Lincoln Family Practice, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 07 Nov 2005 (19 years ago) (Companies founded in November 2005) |
| Entity Number: | 000-244-414 |
| Register Number: | 000244414 |
| ZIP code: | 35096 (Companies in Talladega, 35096) |
| County: | Talladega |
| Place of Formation: | Talladega County |
| Registered Office Street Address: | 1100 PATTON CHAPEL RDLINCOLN, AL 35096 |
| Principal Address: | LINCOLN, AL |
| Authorized Capital: | $1,000 |
Activities
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063523421 | 2006-08-31 | 2022-09-07 | 1100 PATTON CHAPEL RD, LINCOLN, AL, 350964723, US | 1100 PATTON CHAPEL RD, LINCOLN, AL, 350964723, US | |||||||||||||||||||||
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| Phone | +1 205-763-1414 |
| Fax | 2057631447 |
Authorized person
| Name | APRIL L PONDER |
| Role | PRESIDENT |
| Phone | 2057631414 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529927600 |
| State | AL |
| Name | Role |
|---|---|
| PONDER, APRIL | Agent |
| Name | Role | Address |
|---|---|---|
| PONDER, APRIL | Incorporator | No data |
| PONDER, MARK E | Incorporator | 1100 PATTON CHAPEL ROADLINCOLN, AL 35096 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
