| Name: | Willoughby Anesthesia, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 09 Jan 2007 (18 years ago) |
| Date of dissolution: | 10 Apr 2013 |
| Entity Number: | 000-250-569 |
| Register Number: | 000250569 |
| County: | Autauga |
| Place of Formation: | Autauga County |
| Registered Office Street Address: | 213 SWEET BRIAR LANEPRATTVILLE, AL 36067 |
| Registered Office Street Address ZIP Code: | 36067 |
| Principal Address: | PRATTVILLE, AL |
| Authorized Capital: | $100 |
Activities
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326184631 | 2007-01-30 | 2020-08-22 | PO BOX 235022, MONTGOMERY, AL, 361235022, US | 124 S MEMORIAL DR, PRATTVILLE, AL, 360673619, US | |||||||||||||||||||
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| Phone | +1 334-386-2055 |
| Fax | 3343966929 |
| Phone | +1 334-365-0651 |
Authorized person
| Name | HEATHER LANEY BARRON |
| Role | BILLING MANAGER |
| Phone | 3343966930 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| GOLLMAN, DANIEL | Agent |
| Name | Role |
|---|---|
| GOLLMAN, DANIEL | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
