| Name: | Associates in Dermatology, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 16 Jul 2008 (16 years ago) (Companies founded in July 2008) |
| Date of dissolution: | 11 Dec 2023 |
| Entity Number: | 000-258-027 |
| Register Number: | 000258027 |
| Historical Names: |
Dermatology Associates of Birmingham, P.C.
|
| ZIP code: | 35203 (Companies in Jefferson, 35203) |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 420 NORTH 20TH ST STE 1600BIRMINGHAM, AL 35203 |
| Authorized Capital: | $1,000 |
Activities
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699926279 | 2008-10-01 | 2016-09-12 | 46 MEDICAL PARK DR E, SUITE 405, BIRMINGHAM, AL, 352353401, US | 46 MEDICAL PARK DR E, SUITE 405, BIRMINGHAM, AL, 352353401, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 205-836-1212 |
| Fax | 2058361313 |
Authorized person
| Name | DR. JEFFREY NEAL MARTIN |
| Role | PRESIDENT |
| Phone | 2058361212 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| License Number | DO875 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BC/BS OF ALABAMA |
| Number | G-73580 |
| State | AL |
| Issuer | MEDICARE |
| Number | 1083677926 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| MINISMAN, B G JR | Agent | 420 NORTH 20TH STREET SUITE 1400BIRMINGHAM, AL 35203 |
| Name | Role | Address |
|---|---|---|
| MARTIN, JEFFREY N | Director | 7310 COLLEGE PARKWAYFORT MYERS, FL 33907 |
| Name | Role | Address |
|---|---|---|
| MINISMAN, B G JR | Incorporator | 420 NORTH 20TH STREET SUITE 1400BIRMINGHAM, AL 35203 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2014-07-01 | Name Change | Dermatology Associates of Birmingham, P.C. | Associates in Dermatology, P.C. |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
