| Name: | South Otolaryngology-Head and Neck Surgery, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 02 Jan 2014 (11 years ago) (Companies founded in January 2014) |
| Entity Number: | 000-294-251 |
| Register Number: | 000294251 |
| ZIP code: | 36467 (Companies in Covington, 36467) |
| County: | Covington |
| Place of Formation: | Covington County |
| Principal Address: | 511 BRANTLEY STREETOPP, AL 36467 |
Activities
TO ENGAGE IN THE PRACTICE OF MEDICINE
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | South Otolaryngology-Head and Neck Surgery, LLC | LLC_12824971 | ILLINOIS |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881019537 | 2014-03-04 | 2020-04-27 | 2126 W ROY PARKER RD STE 207, OZARK, AL, 363608566, US | 2126 W ROY PARKER RD STE 207, OZARK, AL, 363608566, US | |||||||||||||||||
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| Phone | +1 334-443-0335 |
Authorized person
| Name | DR. TARIK Y FARRAG |
| Role | PRESIDENT/PHYSICIAN |
| Phone | 4438546019 |
Taxonomy
| Taxonomy Code | 207YX0905X - Otolaryngology/Facial Plastic Surgery Physician |
| License Number | MD.32237 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FARRAG, TARIK Y | Agent | 511 BRANTLEY STREETOPP, AL 36467 |
| Name | Role | Address |
|---|---|---|
| FARRAG, TARIK Y | Organizer | 511 BRANTLEY STREETOPP, AL 36467 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
