| Name: | NorthWest Alabama Surgical Specialists, PC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 16 Jun 2010 (14 years ago) |
| Date of dissolution: | 02 Jul 2018 |
| Entity Number: | 000-264-458 |
| Register Number: | 000264458 |
| County: | Winston |
| Place of Formation: | Winston County |
| Principal Address: | HALEYVILLE, AL |
| Registered Office Street Address: | 42030 HWY 195 STE CHALEYVILLE, AL 35565 |
| Registered Office Street Address ZIP Code: | 35565 |
| Authorized Capital: | 100 |
Activities
MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962718650 | 2010-08-19 | 2010-08-19 | PO BOX 1046, HALEYVILLE, AL, 355651046, US | 42030 HIGHWAY 195, SUITE C, HALEYVILLE, AL, 355657054, US | |||||||||||||||||||
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| Phone | +1 205-486-3800 |
| Fax | 2054863802 |
Authorized person
| Name | DR. JEFF RYAN |
| Role | OWNER |
| Phone | 2054863800 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| License Number | 22074 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| THOMAS, SAMUEL B | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
