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Eye Surgical Associates, P.C.

Details

Name: Eye Surgical Associates, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 30 Apr 2008 (17 years ago)
Entity Number: 000-257-161
Register Number: 000257161
County: Houston
Place of Formation: Houston County
Principal Address: DOTHAN, AL
Registered Office Street Address: 103 CHAPEL HILL RDDOTHAN, AL 36305
Registered Office Street Address ZIP Code: 36305
Authorized Capital: $1,200

Activities OPTHALMOLOGY MEDICAL PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1669648879 2008-05-07 2011-11-17 2664 HARTFORD HWY, DOTHAN, AL, 363054904, US 2664 HARTFORD HWY, DOTHAN, AL, 363054904, US

Contacts
Phone +1 334-699-2244
Fax 3346992245

Authorized person
Name DR. JOHN KENNETH WALLACE
Role PRESIDENT
Phone 3346992244

Taxonomy
Taxonomy Code 207W00000X - Ophthalmology Physician
License Number 13178
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EYE SURGICAL ASSOCIATES, P.C. PROFIT SHARING PLAN 2023 262524341 2024-07-22 EYE SURGICAL ASSOCIATES, P.C. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3346992244
Plan sponsor’s address 2664 HARTFORD HIGHWAY, DOTHAN, AL, 36301

Signature of
Role Plan administrator
Date 2024-07-22
Name of individual signing CURINN BALMER
EYE SURGICAL ASSOCIATES, P.C. PROFIT SHARING PLAN 2022 262524341 2023-10-09 EYE SURGICAL ASSOCIATES, P.C. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3346992244
Plan sponsor’s address 2664 HARTFORD HIGHWAY, DOTHAN, AL, 36301

Signature of
Role Plan administrator
Date 2023-10-09
Name of individual signing CURINN BALMER
EYE SURGICAL ASSOCIATES, P.C. PROFIT SHARING PLAN 2021 262524341 2022-10-17 EYE SURGICAL ASSOCIATES, P.C. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3346992244
Plan sponsor’s address 2664 HARTFORD HIGHWAY, DOTHAN, AL, 36301

Signature of
Role Plan administrator
Date 2022-10-17
Name of individual signing CORINA SASSER
EYE SURGICAL ASSOCIATES, P.C. PROFIT SHARING PLAN 2020 262524341 2021-10-13 EYE SURGICAL ASSOCIATES, P.C. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3346992244
Plan sponsor’s address 2664 HARTFORD HIGHWAY, DOTHAN, AL, 36301

Signature of
Role Plan administrator
Date 2021-10-13
Name of individual signing CORINA SASSER
EYE SURGICAL ASSOCIATES, P.C. PROFIT SHARING PLAN 2019 262524341 2020-10-12 EYE SURGICAL ASSOCIATES, P.C. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3346992244
Plan sponsor’s address 2664 HARTFORD HIGHWAY, DOTHAN, AL, 36301

Signature of
Role Plan administrator
Date 2020-10-12
Name of individual signing CORINA SASSER
EYE SURGICAL ASSOCIATES, P.C. PROFIT SHARING PLAN 2018 262524341 2019-07-29 EYE SURGICAL ASSOCIATES, P.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3346992244
Plan sponsor’s address 2664 HARTFORD HIGHWAY, DOTHAN, AL, 36301

Signature of
Role Plan administrator
Date 2019-07-29
Name of individual signing CORINA SASSER
EYE SURGICAL ASSOCIATES, P.C. CASH BALANCE PENSION PLAN AND TRUST 2017 262524341 2018-10-26 EYE SURGICAL ASSOCIATES, P.C. 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3346992244
Plan sponsor’s address 2664 HARTFORD HIGHWAY, DOTHAN, AL, 36305

Signature of
Role Plan administrator
Date 2018-10-26
Name of individual signing SUSAN A. WALLACE
EYE SURGICAL ASSOCIATES, P.C. CASH BALANCE PENSION PLAN AND TRUST 2017 262524341 2018-09-11 EYE SURGICAL ASSOCIATES, P.C. 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3346992244
Plan sponsor’s address 2664 HARTFORD HIGHWAY, DOTHAN, AL, 36305

Signature of
Role Plan administrator
Date 2018-09-11
Name of individual signing SUSAN A. WALLACE
EYE SURGICAL ASSOCIATES, P.C. PROFIT SHARING PLAN 2017 262524341 2018-07-27 EYE SURGICAL ASSOCIATES, P.C. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3346992244
Plan sponsor’s address 2664 HARTFORD HIGHWAY, DOTHAN, AL, 36301
EYE SURGICAL ASSOCIATES, P.C. CASH BALANCE PENSION PLAN AND TRUST 2016 262524341 2017-08-28 EYE SURGICAL ASSOCIATES, P.C. 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3346992244
Plan sponsor’s address 2664 HARTFORD HIGHWAY, DOTHAN, AL, 36305

Signature of
Role Plan administrator
Date 2017-08-28
Name of individual signing SUSAN A. WALLACE

Agent

Name Role
WALLACE, J KENNETH Agent

Incorporator

Name Role
WALLACE, J KENNETH Incorporator

Related by officers

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Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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