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Clark & Hirsch Neurosurgery & Spine, P.C.

Details

Name: Clark & Hirsch Neurosurgery & Spine, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 10 Jul 2013 (11 years ago)
Entity Number: 000-284-685
Register Number: 000284685
Historical Names: SHAWN CLARK, M.D.P.C.
County: Mobile
Place of Formation: Mobile County
Registered Office Street Address: 22 COUNTRY CLUB ROADMOBILE, AL 36608
Registered Office Street Address ZIP Code: 36608
Authorized Capital: 1,000 @ $1.00PV

Activities PRACTICE OF MEDICINE/NEUROLOGICAL SURGERY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1972931533 2013-10-17 2013-10-17 6701 AIRPORT BLVD, #C138, MOBILE, AL, 366086705, US 6701 AIRPORT BLVD, #C138, MOBILE, AL, 366086705, US

Contacts
Phone +1 251-295-2579

Authorized person
Name DR. SHAWN BROXTON CLARK
Role PHYSICIAN
Phone 2512952579

Taxonomy
Taxonomy Code 174400000X - Specialist
License Number 23993
State AL
Is Primary Yes
Taxonomy Code 363AS0400X - Surgical Physician Assistant
License Number 143
State AL
Is Primary No

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CLARK & HIRSCH NEUROSURGERY & SPINE, P.C. 401(K) PLAN 2023 463174682 2024-08-14 CLARK & HIRSCH NEUROSURGERY & SPINE, P.C. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2512872176
Plan sponsor’s address 6701 AIRPORT BLVD STE D-146, MOBILE, AL, 36608

Signature of
Role Plan administrator
Date 2024-08-14
Name of individual signing SHAWN B CLARK MD
CLARK & HIRSCH NEUROSURGERY & SPINE, P.C. 401(K) PLAN 2022 463174682 2023-09-12 CLARK & HIRSCH NEUROSURGERY & SPINE, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2512872176
Plan sponsor’s address 6701 AIRPORT BLVD STE D-146, MOBILE, AL, 36608

Signature of
Role Plan administrator
Date 2023-09-12
Name of individual signing SHAWN B CLARK MD
CLARK & HIRSCH NEUROSURGERY & SPINE, P.C. 401(K) PLAN 2021 463174682 2022-09-28 CLARK & HIRSCH NEUROSURGERY & SPINE, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2512872176
Plan sponsor’s address 6701 AIRPORT BLVD STE D-146, MOBILE, AL, 36608

Signature of
Role Plan administrator
Date 2022-09-28
Name of individual signing SHAWN B CLARK MD
CLARK & HIRSCH NEUROSURGERY & SPINE, P.C. 401(K) PLAN 2020 463174682 2021-02-09 CLARK & HIRSCH NEUROSURGERY & SPINE, P.C. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2512872176
Plan sponsor’s address 6701 AIRPORT BLVD STE D-146, MOBILE, AL, 36608

Signature of
Role Plan administrator
Date 2021-02-09
Name of individual signing SHAWN B CLARK MD
CLARK & HIRSCH NEUROSURGERY & SPINE, P.C. 401(K) PLAN 2019 463174682 2020-03-19 CLARK & HIRSCH NEUROSURGERY & SPINE, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2512872176
Plan sponsor’s address 6701 AIRPORT BLVD STE D-146, MOBILE, AL, 36608

Signature of
Role Plan administrator
Date 2020-03-19
Name of individual signing SHAWN B CLARK MD
CLARK & HIRSCH NEUROSURGERY & SPINE, P.C. 401(K) PLAN 2018 463174682 2019-07-18 CLARK & HIRSCH NEUROSURGERY & SPINE, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2512872176
Plan sponsor’s address 6701 AIRPORT BLVD STE D-146, MOBILE, AL, 36608

Signature of
Role Plan administrator
Date 2019-07-18
Name of individual signing SHAWN B CLARK MD
CLARK & HIRSCH NEUROSURGERY & SPINE, P.C. 401(K) PLAN 2017 463174682 2018-06-01 CLARK & HIRSCH NEUROSURGERY & SPINE, P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2512872176
Plan sponsor’s address 6701 AIRPORT BLVD STE D-146, MOBILE, AL, 36608

Signature of
Role Plan administrator
Date 2018-06-01
Name of individual signing SHAWN B CLARK MD
CLARK & HIRSCH NEUROSURGERY & SPINE, P.C. 401(K) PLAN 2016 463174682 2017-07-14 CLARK & HIRSCH NEUROSURGERY & SPINE, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2512872176
Plan sponsor’s address 6801 AIRPORT BLVD C-138, MOBILE, AL, 36608

Signature of
Role Plan administrator
Date 2017-07-14
Name of individual signing SHAWN B CLARK MD

Agent

Name Role Address
CLARK, SHAWN B Agent 22 COUNTRY CLUB ROADMOBILE, AL 36608

Director

Name Role Address
CLARK, SHAWN B Director 22 COUNTRY CLUB ROADMOBILE, AL 36608

Incorporator

Name Role Address
CLARK, SHAWN B Incorporator 22 COUNTRY CLUB ROADMOBILE, AL 36608

Events

Event Date Event Type Old Value New Value
2017-01-20 Name Change SHAWN CLARK, M.D.P.C. Clark & Hirsch Neurosurgery & Spine, P.C.

Related by officers

No related officers

Related by address

22 COUNTRY CLUB ROADMOBILE, AL 36608

Silence Dogood LLC

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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