| Name: | Fowler Sports Medicine and Orthopaedics II, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 02 Feb 2006 (19 years ago) (Companies founded in February 2006) |
| Date of dissolution: | 29 Dec 2021 |
| Entity Number: | 000-245-535 |
| Register Number: | 000245535 |
| ZIP code: | 35401 (Companies in Tuscaloosa, 35401) |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Registered Office Street Address: | DCH MEDICAL TOWER 1 STE 205TUSCALOOSA, AL 35401 |
| Authorized Capital: | $5,000 |
Activities
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366501223 | 2006-12-07 | 2009-03-10 | 100 RICE MINE ROAD LOOP, SUITE 205, TUSCALOOSA, AL, 354062419, US | 100 RICE MINE ROAD LOOP, SUITE 205, TUSCALOOSA, AL, 354062419, US | |||||||||||||||||||||||||||||
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| Phone | +1 205-752-1800 |
| Fax | 2057521891 |
Authorized person
| Name | DR. HOWARD L FOWLER |
| Role | PRESIDENT |
| Phone | 2057521800 |
Taxonomy
| Taxonomy Code | 207X00000X - Orthopaedic Surgery Physician |
| License Number | 00013227 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529932889 |
| State | AL |
| Name | Role |
|---|---|
| FOWLER, H LESLIE | Agent |
| Name | Role | Address |
|---|---|---|
| ADCOX, C BARTON | Incorporator | 2205 4TH STREET, SUITE 21TUSCALOOSA, AL 35401 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
