| Name: | Southside Family Medicine Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 16 May 2007 (18 years ago) (Companies founded in May 2007) |
| Entity Number: | 000-252-728 |
| Register Number: | 000252728 |
| ZIP code: | 35907 (Companies in Etowah, 35907) |
| County: | Etowah |
| Place of Formation: | Etowah County |
| Principal Address: | SOUTHSIDE, AL |
| Registered Office Street Address: | 1602 HWY 77SOUTHSIDE, AL 35907 |
| Authorized Capital: | 500 |
Activities
FAMILY PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649463431 | 2007-08-24 | 2007-08-24 | 1602 HIGHWAY 77, SOUTHSIDE, AL, 359070100, US | 1602 HIGHWAY 77, SOUTHSIDE, AL, 359070100, US | |||||||||||||||||||
|
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| Phone | +1 256-442-7423 |
| Fax | 2564426762 |
Authorized person
| Name | DR. LISA A FLORENCE |
| Role | VICE PRESIDENT |
| Phone | 2564427423 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | D0920 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FLORENCE, LISA | Agent | 3410 32ND AVENUE NORTHBIRMINGHAM, AL 35207 |
| Name | Role |
|---|---|
| DANIELS, CURTIS | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
