| Name: | Cornerstone General Surgery Clinic, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 29 Oct 2013 (11 years ago) (Companies founded in October 2013) |
| Entity Number: | 000-290-552 |
| Register Number: | 000290552 |
| ZIP code: | 35976 (Companies in Marshall, 35976) |
| County: | Marshall |
| Place of Formation: | Marshall County |
| Registered Office Street Address: | 2019 HAULAPAI LANEGUNTERSVILLE, AL 35976 |
| Authorized Capital: | 10,000@$1.00 PV |
Activities
OPERATE A GENERAL SURGERY/MEDICINE PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366870362 | 2013-10-29 | 2014-05-19 | PO BOX 14149, BATON ROUGE, LA, 708984149, US | 1939 PATTERSON ST STE 102, GUNTERSVILLE, AL, 359762017, US | |||||||||||||||||||||||||
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| Phone | +1 225-930-0060 |
| Fax | 2259529075 |
Authorized person
| Name | MR. KEITH MONK |
| Role | PRESIDENT |
| Phone | 2259300060 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| License Number | 26404 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 154531 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| MONK, TIMOTHY K | Agent | 2019 HAULAPAI LANEGUNTERSVILLE, AL 35976 |
| Name | Role | Address |
|---|---|---|
| MONK, TIMOTHY KEITH | Director | 2019 HAULAPAI LANEGUNTERSVILLE, AL 35976 |
| MONK, CYNTHIA LYN | Director | 2019 HAULAPAI LANEGUNTERSVILLE, AL 35976 |
| Name | Role | Address |
|---|---|---|
| MONK, TIMOTHY K | Incorporator | 2019 HAULAPAI LANEGUNTERSVILLE, AL 35976 |
| MONK, CYNTHIA L | Incorporator | 2019 HAULAPAI LANEGUNTERSVILLE, AL 35976 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
