| Name: | North Alabama Internal Medicine, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 12 Sep 2006 (18 years ago) (Companies founded in September 2006) |
| Entity Number: | 000-249-148 |
| Register Number: | 000249148 |
| ZIP code: | 35601 (Companies in Morgan, 35601) |
| County: | Morgan |
| Place of Formation: | Morgan County |
| Principal Address: | DECATUR, AL |
| Registered Office Street Address: | 1201 SOMERVILLE RD SEDECATUR, AL 35601 |
| Authorized Capital: | $5,000 |
Activities
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356437503 | 2006-10-05 | 2009-12-11 | 1201 SOMERVILLE RD SE, DECATUR, AL, 356014340, US | 1201 SOMERVILLE RD SE, DECATUR, AL, 356014340, US | |||||||||||||||||||||||||||||||
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| Phone | +1 256-350-1773 |
| Fax | 2563505520 |
Authorized person
| Name | DR. JEFFREY ALLEN JOHNSON |
| Role | PRESIDENT |
| Phone | 2563501773 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | DO701 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 051004703 |
| State | AL |
| Issuer | AETNA |
| Number | 7446374 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| JOHNSON, JEFFREY A | Agent | 535 Bayou Sara AveSaraland, AL 36571 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, JEFFREY A | Incorporator | 535 Bayou Sara AveSaraland, AL 36571 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
