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Hillside Family Practice, P.C.

Details

Name: Hillside Family Practice, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Dissolved
Date of registration: 21 Feb 2008 (17 years ago) (Companies founded in February 2008)
Date of dissolution: 31 Dec 2019
Entity Number: 000-256-210
Register Number: 000256210
ZIP code: 36467 (Companies in Covington, 36467)
County: Covington
Place of Formation: Covington County
Principal Address: OPP, AL
Registered Office Street Address: 103 EAST MEMORIAL DROPP, AL 36467
Authorized Capital: $500
Paid Share Capital: $100

Activities MEDICAL PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1255504866 2008-04-04 2015-08-28 1008 BOLL WEEVIL CIR, SUITE B, ENTERPRISE, AL, 363301312, US 1008 BOLL WEEVIL CIR, SUITE B, ENTERPRISE, AL, 363301312, US

Contacts

Phone +1 334-475-2067

Authorized person

Name DAVID RYAN
Role OWNER
Phone 3344752067

Taxonomy

Taxonomy Code 207Q00000X - Family Medicine Physician
License Number DO1000
State AL
Is Primary Yes

Agent

Name Role
RYAN, DAVID N ARTHUR Agent

Incorporator

Name Role
RYAN, DAVID N ARTHUR Incorporator

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State