| Name: | Chilton Surgical Associates, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 05 Jun 2013 (11 years ago) |
| Entity Number: | 000-283-641 |
| Register Number: | 000283641 |
| County: | Chilton |
| Place of Formation: | Chilton County |
| Registered Office Street Address: | 1006 LAY DAM ROADCLANTON, AL 35045 |
| Registered Office Street Address ZIP Code: | 35045 |
| Authorized Capital: | 100 @ $10.00 PV |
Activities
PRACTICE OF MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912342205 | 2013-05-01 | 2021-10-14 | 1006 LAY DAM RD, CLANTON, AL, 350452306, US | 1911 LAY DAM RD, CLANTON, AL, 350458351, US | |||||||||||||||||||||||||
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| Phone | +1 205-280-3248 |
| Fax | 2052803369 |
Authorized person
| Name | DR. JON ERIC BINKERD |
| Role | CHIEF SURGEON |
| Phone | 2052803248 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| License Number | 31935 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 149637 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| BINKERD, JON E | Agent | 1006 LAY DAM ROADCLANTON, AL 35045 |
| Name | Role | Address |
|---|---|---|
| BINKERD, JON E | Incorporator | 1006 LAY DAM ROADCLANTON, AL 35045 |
| Name | Role | Address |
|---|---|---|
| BINKERD, JON E | Director | 1006 LAY DAM ROADCLANTON, AL 35045 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
