| Name: | Dr. Michael Johnson & Associates, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 22 Aug 2006 (18 years ago) |
| Entity Number: | 000-248-812 |
| Register Number: | 000248812 |
| County: | Marshall |
| Place of Formation: | DeKalb County |
| Principal Address: | GUNTERSVILLE, AL |
| Registered Office Street Address: | 3446 HWY 69 SOUTHGUNTERSVILLE, AL 35976 |
| Registered Office Street Address ZIP Code: | 35976 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $5,000 |
Activities
OPTOMETRY PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043596216 | 2011-11-01 | 2022-09-26 | 236 BARRINGTON CIR, ALEXANDRIA, AL, 362507205, US | 1413 RAINBOW DR, GADSDEN, AL, 359015386, US | |||||||||||||||||||||||||||
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| Phone | +1 256-452-1572 |
| Fax | 2565461094 |
| Phone | +1 256-543-8886 |
Authorized person
| Name | DR. JAY MICHAEL JOHNSON |
| Role | DOCTOR OWNER |
| Phone | 2565438886 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | SB35TA733 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 09940954 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| JOHNSON, MICHAEL | Incorporator | 3055 SOCIETY HILL ROADOPELIKA, AL 36804 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, MICHAEL | Agent | 3055 SOCIETY HILL ROADOPELIKA, AL 36804 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
